Re: PSA
"Or is it all self-tuning and autonomous for all but the most esoteric setups?"
More or less.
You can get cheap all-flash storage arrays that can do 100,000 x more IOPS than you had access to during the classical period, and of course nobody runs databases against pentium 3s with only a few Mb of RAM...
So unless you have top tier requirements It's easy to just throw hardware at a problem to make poor design go away.