The reality is that cloud providers make it easy to deploy infrastructure without much thought. You need skilled domain specific IT Architects working together to ensure that an organization's cloud presence is efficient and secure. That discipline and rigor is often dismissed or underappreciated because it forces you to slow down and decreases agility.

Some organizations have some form of Enterprise Architecture group that governs technology and ensures that there is discipline though the maturity and scope varies. I would say most organizations are completely devoid of that type of supervision and oversight.