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Any Elixir/Gleam/Erlang (distributed) support?

I don't know! I do see a Docker image for Elixir, so I'm pretty sure that would work. But the distributed aspect is harder to answer right now.

How do you typically deploy this?

Render (because it's on k8s) and Fly handle distributed erlang out of the box, so I don't have to think much about it. Heroku does not.