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For each person you kill, BB's hp will decrease. IIRC its 5 enemies killed before BB goes into autotoxemic shock and you will have to rest in a knot or safehouse to bring it back.
All people killed will have to be disposed of either in a tar lake or in an incinerator. Otherwise you risk a game over screen from a voidout after 12 hours.
If you kill everyone on the map in all camps then they will never respawn (not confirmed). However materials will also not respawn. If however you leave at least 1 person alive in a camp, then all materials will keep spawning as they usually do.
It seems that all camps get repopulated during Chapter 10 IIRC regardless of whether you have killed everyone or not, so you would have to kill them all again I guess. I have not tested killing everyone on the map after the final mission; however there are at least two sources that claim enemies never returned after many many hours.
Personally I like keeping them alive since the world feels a bit more alive that way. Plus I don't know if Sam is really a cold blooded killer.