I think an audiologist can give you a formal diagnosis if you want one, but if you are on the spectrum, I'm not sure if an audiologist can help. I suspect that it's a part of sensory processing issues, at least in my case. I can hear pretty well for a person in her forties (like I can hear a ball of paper hit the floor), but if there is background noise, a person talking to me will just sound like they are making nonsensical buzzing noises. I also have significant problems processing speech even in the best of conditions, according to the psychologist who screened me for ASD. I lose track of the conversation or get the words mixed up. If I go to happy hour with my co-workers, I usually just sit there trying to figure out what everyone is talking about.
I try to tell people I have difficulties hearing people if there is background noise (I don't mention the Aspgerger's). People do still get angry for some reason. I ignore them, if possible, or go to their manager if it's something I really need or I just got annoyed enough to complain. It seems more to be an issue with people in lower paying jobs or industries where there are likely to be a lot of angry customers (like my local subway system, which breaks down regularly).
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Diagnosed Bipolar II in 2012, Autism spectrum disorder (moderate) & ADHD in 2015.