I use Citus. Their team is great, but it is very expensive.
The move from AWS to Azure came with a reduction of IOPS per instance. We have not had the same level of performance since migrating to Azure.
I am considering running our own Citus instances.
It's also amenable to distributed processing if you use something like Citus.
I'm really looking for an alternative to Citus, though. Citus itself is a bit tricky to use, and the SaaS version of it is owned by Microsoft, which means Azure-only. Also, Microsoft makes the SaaS version insanely expensive. If they had Citus-like features on Amazon Aurora I'd be there in a heartbeat.