To add another data point, I've been hosting a (tiny) matrix server for a few months. I'm pretty comfortable with self-hosting using docker, so I opted not to use the ansible scripts in the hope that it'd keep my setup simpler and more maintainable. Somehow I didn't find any mentions of ESS until Synapse was already up and running, but Kubernetes would have been a dealbreaker for similar reasons.

In this short time I've run a database migration (sqlite is the default, but MAS requires postgres), tried and failed to migrate to MAS (required to use Element X) and have lost a couple of days messing around with coturn and eturnal with nothing to show for it -- my calls still don't connect when NAT is involved. I have to tell new users to ignore the recommendations to install Element X until I get MAS working.

There's a lot of room for foundational improvements here, even updating docs to point would-be server admins to the recommended setup du jour would help.