It depends on the scale - it does not have to be a major undertaking. You are right, it is
a whole extra competency and a major customer support commitment, but for a lot of the entrepreneurial folk on HN quite a rewarding and accessible learning experience.
The first time I did anything like this was in late 1984 in a small town in Iowa where GTE was the local telecommunication utility. Absolutely abysmal Internet service, nothing broadband from them at the time or from the MSO (Mediacom). I found out there was a statewide optical provider with cable going through the town. I incorporated an LLC, became a utility and built out less than 2 miles of single mode fiber to interconnect some of my original software business customers at first. Our internal moto was "how hard can it be?" (more as a rebuke to GTE). We found out. The whole 24x7 public utility thing was very difficult for just a couple of guys. But it grew from there. I left after about 20 years and today it is a thriving provider.
Technology has made the whole process so much easier today. I am amazed more people do not do it. You can get a small rack-mount sheet metal pedestal with an AC power meter and an HVAC unit for under $2k. Being a utility will allow you to place that on a concrete pad or vault in the utility corridor (often without any monthly fee from the city or county). You place a few bollards around it so no one drives into it. You want to get quotes from some tier 1 providers [0]. They will help you identify the best locations to engineer an optical meet and those are the locations you run by the city/county/state utilities board or commission.
For a network engineer wanting to implement a fault tolerant network, you can place multiple pedestals at different locations on your provider's/peer's network to create a route diversified protected network.
After all, when you are buying expensive cloud based services that literally is all your cloud provider is doing ... just on a completely more massive scale. The barrier to entry is not as high as you might think. You have technology offerings like OpenStack [1], where multiple competitive vendors will also help you engineer a solution. The government also provides (financial) support [2].
The best perk is the number of parking spaces the requisite orange utility traffic cone opens up for you.
[0] https://en.wikipedia.org/wiki/Tier_1_network
[1] https://www.openstack.org/
[2] https://www.usda.gov/reconnect