But guiding that 60 year old lady through configuring her company phone is how you discover that your process for configuring company phones is broken. When the people who design a system never interact with the people who use the system, that is how you end up with shitty unusable IT systems.

If you are unwilling to get your hands dirty interacting with the people who use your network you'll be unaware of how your decisions affect their day to day lives and consequently they'll probably end up hating you, which will not do you any favors in the long run. It is important to remember that everything you do is ultimately in service to helping them do their jobs.

Our IT is two things, one is helpdesk the other is “tech”. Tech handles servers, networking, security and Azure and only really offer support for developers like me.

Same here

Network/infrastructure guys don't seem to me to do helpdesk very often?

What do you think happens when a core core router breaks? The level one guy fixes it?

There are a few Palo Alto and Cisco guys near me. They definitely aren’t answering the help desk phone but they are level 3 support. Same with my development team.

Not to mention large orgs have NOCs dedicated to this. The last company I was at at a couple CCAs in the NOC. They were smart but an odd breed.

It depends on the size of the company.

These will be separate jobs in any large enough IT org.