We can agree to disagree, but the tooling has definitely saved me enough time to be worth it. That and realistically, no matter the DB chosen, you either use DB specific features or leave performance (often substantial) on the table.
What specifically are you referring to (regarding tooling)? Do you mean running it on Azure as a managed service that auto scales, programming tools/frameworks like LINQ, or client side GUI tools?
From an automation perspective not having a decent CLI for MSSQL to facilitate scripting makes it a pain from day one.
We use Database projects in Visual Studio, so all our schema, stored procedures, and other scripts are in version control. We can compile them (additional validation) into dacpac packages, and script updates and deployment to local instances and Azure with sqlpackage and sqlcmd.
That said, the code is in C# as well (and not .NET core, from what I saw), so they're pretty tied to Windows anyway, which is awkward since this is a macOS app.