None of this is any different I a cloud setup. You still need to check the integrity of your backups. You still need to have appropriate failover. The effort is pretty much the same. In a competent setup it's automated, so you're not spending an hour a month per server. Not even for the production DB server, because you have replicas and setups to automate the switch, and setups to bring back snapshots from backups.

Been there, done that, many times, and I know exactly what it costs people, because I billed by the hour for it, and your cost assumptions are just way off.