The Principal PM in charge of the "regionalization" effort was asked in a Q&A "why didn't we just switch to IPv6?".
Her answer was something along the lines of "The number of internal networking devices we currently have that cannot support IPv6 is so large that to replace them we would have needed to buy nearly the entire world's yearly output of those devices, and then install them all."[0]
It's easy to presume malicious intent on the IPv4 front from Amazon, but with so many AWS systems being on the scale they are at, I find it easy to believe that replacing all of the old network hardware may just be a project too large to do on a short timescale.
[0] - At least, that's my memory of it. I'm sure that's not an entirely accurate quotation.