These requests can be granted manually or automatically but they need to be logged and stored. Sometimes requests are required for every single access of a tool and sometimes it's time period based (24 hour access to Redshift or whatever) -- usually this depends on your role in an org. There isn't a coherent out-of-the-box way to provide the authorization and access gateways across all the different tools a business relies on -- so there is a big business opportunity for companies to basically provide turnkey identity and access management tools for companies.
Or, occasionally, an engineer loses their mind with the inefficiencies of these systems and processes and goes off on a jag to create the perfect internal tool to solve all these problems. That rarely (if ever) works, hence the video.