If you're building your own framework and server, then yes. Otherwise, all major frameworks handle the communication with uwsgi, etc and you can treat them as a blackbox. Any other setup in-between (like nginx -> uwsgi) is boilerplate stuff easily found in tutorials or LLM chat.
What's become a pain about DB migrations? They've barely changed and they are still so amazingly useful that you forget it's something you have to think about until you move to another framework that doesn't have them.
My half aunt who never knew who her father (my grandfather) was found my family through 23 and me relative matching. That's life changing, not gimmicky.