I mean, that, as a minimum, means you're running and maintaining a Windows server, along with antivirus, backups for the OS, and backups for the database. Any time Windows updates come along, your service will be unavailable. Every couple of years, you'll need to buy a new license, upgrade Windows, and make sure everything comes up smoothly. This likely will involve fixing and troubleshooting some issues. You'll need to have some monitoring set up to make sure you don't end up running out of disk space on Saturday morning.
Or maybe you have more than one Windows server (to avoid downtime from a single server), but that makes your stack decidedly less "boring." Now you're dealing with at least a load balancer and making SQL Server redundant.
I mean, I guess it's more boring than chasing the latest front-end reinvention or maintaining MongoDB, but there's some room for improvement here, clearly. Containerized deployments (via Docker or a "serverless" architecture) might be able to help.