When I last tried, it, AWS RDS still required EBS-backed disks. It may be acceptable for 99% of use cases, but that means there's a ceiling around 60k IOPS, even with PIOPS disks.

Outside of RDS, you're afforded a bit more creativity in your performance profile: multiple disks in RAID 0, tiered storage (burstable AND, rather than OR, provisioned IOPS storage), and instance store, to name a few. I actually once witnessed one of our databases riding out a 400K IOPS storm for a few minutes.

Before I get downvoted: yes, these introduce risk into your data architecture. It's crucial to understand what these choices will do to your failure profile, and plan accordingly. In our case, fast-failover to a hot spare database, combined with total recovery within two hours, was enough of a compensating factor to manage that risk.