Let $A$ be an additive category, with objects $X$ and $Y$. If there exists direct sum decompositions $X = Y\oplus Y'$ and $Y = X \oplus X'$ in $A$, must $X$ and $Y$ be isomorphic?
If one only assumes that there exist monomorphisms $X\to Y$ and $Y\to X$, the answers is No in the category of abelian groups, as explained in answers linked to in the comments. However, the question about direct summands is not resolved there.