Why would an organization choose to use SQL Server on Azure VM?

Organizations often choose to use SQL Server on Azure Virtual Machines (VMs) primarily for scenarios requiring the full features of SQL Server, particularly when dealing with legacy applications. This setup allows them to leverage their existing SQL Server licenses and migrate applications that are tightly integrated into SQL Server environments without having to refactor or redesign them. Running SQL Server on an Azure VM provides the complete SQL Server experience, including support for features that may not be available in other Azure database services, thus ensuring compatibility and continuity for legacy systems.

This approach is also beneficial for businesses that have specific requirements regarding the SQL Server editions, features, or performance configurations that cannot be met by managed services. Users can have full control over the SQL Server instance, which allows for customized configurations, administrative privileges, and the ability to install any additional software required for their applications.

Although minimal management and benefits like automatic updates, backups, and reduced security risks are desirable features, they are more prominently associated with Azure's managed database services, such as Azure SQL Database or Azure SQL Managed Instance, rather than traditional SQL Server deployed on VMs.