Check out the first few episodes of Casey Muratori's Handmade Hero series where he implements an extremely simple hot code reloading system in C (actually C++, but he doesn't use almost any C++ features, certainly not vtables).
if you don't want to watch the video, here is a basic overview tldw; of the technique:
on every run of the game loop(usually every frame), reload a dynamically linked module (dll for windows, .so for linux), which contains the actual code you want to run every frame. The function you then invoke from the module must be passed the entire block of memory allocated for the game state. You then just recompile the dll/so module when you make a change, and the game would execute the new code on the next frame. Adding new data structures is OK as long as you don't mangle an existing data structure...but because a game can expect to work with a constant block of pre-allocated memory, this actually works fine most of the time...
yes - but different OS have different ways to load dynamically linked modules, and the casey video only showed the windows method. But it's basically the same, just library calls differently named.