I don't work with the Windows API much, but I've seen it used there as well as occasionally in a codebase here at work.
When Microsoft updates a function and the new function is incompatible with the old one, Microsoft continues to support the old function. The new function keeps the same name as the old function, with added -Ex suffix. Follow this answer to receive notifications.
Yup, they wanted to improve (Extend) the API and keep a similar name so it was likely that the programmer would move to the new version.
Notable is GetVersionEx() to get the Windows version, pretty painful for a while with a nasty chicken-and-egg problem.
The record keeper is the National Language Support team who have several ExEx versions, like EnumCalendarInfoExEx. Unsurprising, culture moves even faster than software. No ExExEx as of yet.
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