Remember not everybody has the luxury of working on a system where you can spawn 10,000 threads without breaking a sweat.
However this territory of literally hundreds of thousands of programmed agents participating in a game does not seem to be very populated. Perhaps part of the reason is that very few languages had efficient (this eliminates stack copying), scalable and portable support of coroutines. This is starting to change, but not as fast as I would like.
I think C is to be blamed for the long under appreciated status of coroutines. It is one abstraction that C left out, although the VM C had as its execution model (the PDP) had excellent support for coroutines at the instruction level. C exported pretty much every abstraction of the underlying instruction set, but not coroutines.
EDIT: @VikingCoder Replying here as HN wouldnt allow me to respond till some time has past. Yes I have looked at asio although just scratched the surface. It looks very interesting, as far as I know they are not threads though (which is a good thing), they use macro and template metaprogramming trickery to turn producer-consumers into one big switch case. If you interested in coroutines and seamless interaction with C++ I can recommend http://felix-lang.org