You dont need an ORM for testing your code...
But I think this varies from project to project. How many different applications, in different languages are using your db and do you tolerate downtime?
All of the manual sign off steps are integrated with the automated release pipeline. As soon as the required approvals sign off, the next step of the pipeline is done.
Rolling back is just redeploying the previous released version. Branching, source control, etc is also a lot easier when all of your business logic is in code and you don't have to sync up the "right" version of your source control with the right version of your stored procedures.
Of course this is even easier when you're using a NoSql solution where your schema is also defined by your class models. But that's another discussion.....
Of course this doesn't have to just apply to code. With things like Packer and Terraform you can do the same with infrastructure. Automated infrastructure deployment is not my expertise...yet