We're a B2B shop migrating to MSSQL, from SQL Anywhere. Managed MSSQL in Azure is fairly easy operationally, especially since we don't have a dedicated DBA and our support staff aren't SQL gurus.
However since we now got the tools for running on both, and experience migrating, we might be moving to PostgreSQL at some point in not too distant future. Managed MSSQL in Azure is not cheap.
If you started on SQL Anywhere, SAP, you were pretty deep in Enterprise sauce so MSSQL make sense.
And "Holy crap, this is not cheap" is why I see plenty of companies transitioning off MSSQL.