We give several sufficient conditions for uniform exponential growth in the setting of virtually torsion-free hierarchically hyperbolic groups. For example, any hierarchically hyperbolic group that is also acylindrically hyperbolic has uniform exponential growth. In addition, we provide a quasi-isometric characterizations of hierarchically hyperbolic groups without uniform exponential growth. To achieve this, we gain new insights on the structure of certain classes of hierarchically hyperbolic groups. Our methods give a new unified proof of uniform exponential growth for several examples of groups with notions of non-positive curvature. In particular, we obtain the first proof of uniform exponential growth for certain groups that act geometrically on CAT(0) cubical groups of dimension 3 or more. Under additional hypotheses, we show that a quantitative Tits alternative holds for hierarchically hyperbolic groups.