With the ease of services like AWS, we never installed a database server. Pick a database flavor, version, click, click and you're up. I suppose designing the schema take a little effort, but I find it much easier than properly architecting software.
Many if not most installations are still being done on actual dev machines and servers. While RDS and other managed services are nice, they're just a small fraction of the usage.
Also the fact that managed services help so much only speaks to the fact of how difficult these relational databases typically are to work with operationally.
