Sure, I can do all that by myself but that takes time, time that is better spent serving my clients instead of setting up yet another replicated db. It takes me a few minutes to setup an Amazon RDS instance with all that enabled out of the box.
a) do not have service that operates 24x7
b) do not have peopleware needed for 24x7 operations
c) service customers that do not have 24x7 operations
A metric boat load of now shuttered "startups" would have been going concerns providing very nice long term living (and retirement) to their owners had they been optimized for "not spending 109% of revenue for Yet Another Thing We Should Use As a Service".
Oh to have those problems
In our (Intercom) case these tasks are not simple.
We are lucky to have had exponential growth in most metrics (including database throughput) for the entire 7 years of our existence. This is a harsh environment for datastores! A 99.9% SLA makes it even harder.
We are also nowhere near finished building out our vision for the product. We prefer to focus on that instead of operating data stores, which we can pay someone else to do.
Oh and before someone says "we outsource fixing our toilets to plumbers" - in this case we are not event talking about replacing a flap, we are talking about being able to use a plunger.