I handle our company's RDS instances, and probably spend closer to 2 hours a year than 2 hours a month over the last 8 years.

It's definitely expensive, but it's not time-consuming.

Of course. But people also have high uptime servers with long-running processes they barely touch.

Very much depends on what you're doing in the cloud, how many services you are using, and how frequently those services and your app needs updates.