It's much easier to setup and forget basic bare metal servers with PG/NGINX and whatnot, than it is to automate using dozens of AWS services.
People pretend that AWS doesn't cost engineers to run it, when it's IMO basically the same human cost, if not bigger as complexity grows. You just don't pay that cost upfront, but you sure do pay it later with interest.
You get stuff like HA but that's not free. You also now have to manage a new boatload of services, scripts, changing APIs, etc.
3 years fast forward with hundreds of customers, and we haven't had a need to hire someone full time to "manage" these services. This may/will change down the line, but I couldn't have built my business without one of these cloud vendors.
Edit: I also know the pain of building (and managing) this on bare metal (last company did that) - and it was just apache/php/mysql on bare metal. It was a mess
Huge difference b/w reading a few pages of documentation on secrets manager, and clicking a button to get the service on vs deploying, and maintaining a vault on bare machines.