A cookie won't fit all that data and a more traditional database generally won't work. In memory k/v stores like Redis won't work due to data size (TBs of data). Hbase/Cassandra/etc sort of work with latency in the 5ms range. That's fairly expensive in a 90ms SLA, but you can make it work. It does limit the amount of work you are able to do.
Yeah, but when that happens I usually don't think, oh hey they are lacking an optimal in memory distributed database solution.
I think, well... their engineers suck. Or they don't care. Pick one.
edit: His point is vague, so there is nothing technical to respond to. I am very much interested in a good technical example - but the things mentioned so far are by all appearances relatively straight-forward and linear, hence lack of effort or bad engineering are the only reasonable assumptions left.
Like most problems, scale makes it hard.
With a real-time data stack you can avoid the duplicated ad a good percent of the time. Better experience for buyers, for publishers, and for users.