We don't use AWS/etc, we have 3 colo spaces in various locations around the country. We've never visited two of them; a small fee gets your equipment racked and connected, and remote hands does the rest as needed. The local one we visit maybe 3 times a year, usually to install new equipment.

The overhead of dealing with hardware, especially for applications that don't have massive exponential growth, is really not as big of a deal as it sounds.