If you don’t use serverless but instead a few (vertically scaling) servers, and your ORM / query builder supports pooling (all node libraries I’ve used have a pooler)…

Having a setup with just a simple docker deploy, running a monolith, not using pgbouncer so you can use LISTEN/NOTIFY to implement your own job queue:

https://www.dbos.dev/blog/postgres-listen-notify-scalability

This gives me warm fuzzy feelings, also making me relatively cloud-agnostic in the process, even though devops is not my strong point.

Most projects I do don’t need something more complex or vendor locked-in than this.