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That depends on several factors. The database you might want to run may not be available for instance.

I'm still waiting on that managed PostgreSQL 12 service....

Almost....

PostgreSQL 12.0 Now Available in Amazon RDS Database Preview Environment

https://aws.amazon.com/about-aws/whats-new/2019/11/postgresq...

I would never use a managed database service again.

Managed databases are quite good. RDS is very mature and does a very good job with fail over, backups and is very easy to setup.

I don't want to manage anything that needs to be clustered. Technologies like that often need trained engineers with good knowledge of how the product behaves if we want to manage it ourselves.

Alas it's the only way to get decent efficiency on certain cloud platforms. However, you often can't get the custom plugin and modules. On amazon bare metal ephemeral disk instances are decent high performance alternatives but you can't beat aurora for most pg usecases.

This sounds like the first line in a novel.

Unfortunately, "Nor would I use cloud-based document storage" is the next, and last, sentence.

Well, plenty of people do...

Why?