I've never had a positive experience with Node.js and SQL databases in general to be honest. I don't really see the point in using it outside of familiarity with JavaScript. Nest + TypeORM might be as good as it gets in the Node world right now, but pretty much every other major platform has better ORMs and better frameworks. Node might have better performance and concurrency options than some of the others, but it's not the best at those either. It's not really clear to me that it's actually the best at anything. My preference is honestly just to avoid it. In my experience there is always a better tool.