I once made a 'file system' to mount cpio archives (read-only) in an embedded system. Cpio is an extremely simple format to generate and edit (in code) and mounting it directly was very effective.
I think it'd be viable for an enterprise-y database to do IO directly over NVMe. Imagine the efficiency and throughput gains you could get from a database that (1) has a unified view of memory allocation in the system (2) directly performs its page-level IO on the storage devices.
https://www.pdl.cmu.edu/PDL-FTP/Storage/ceph-exp-sosp19.pdf
There are definitely some significant benefits you can get from managing your own storage, rather than using a filesystem.
It isn't just about performance gains, which are substantial, it also greatly simplifies the design and code by eliminating edge cases, undesirable behaviors, and variability in behavior across different deployment environments.