Look at cloud spend - how many of your employers have measured the ROI of using cloud vs. self-hosting? At a certain point these things just become the cost of doing business I suppose.
Every single one minus Federal Gov. if you are in a leader position you absolutely should be assessing hosting options, trade offs, costs etc, and looking forward as things grow to make sure you aren’t just burning cash. Only my experience from Australia, the low interest environment could be different in the US, but I would expect this attitude to change if interest rates stay above 5%.
Of the 4 series A-B startups I've helped grow, none have measured and made decisions on cloud spend based on measurement. The only time this came up is when bills got too large and spend needed to be controlled. You're right that it may be a difference of environment (USA here)