This so much. People too often treat databases as magical black-boxes that should handle anything. Database is most often the bottleneck and choosing the proper storage engine with appropriate data structures can be 100x more efficient that just using the defaults. 1 server vs 100 can definitely make a noticeable difference in costs and system complexity.
While premature optimization is bad, choosing the right tool for the job is still somewhat important and will usually pay off in the long run.