I can guarantee you that they are wasting more than 200/month of an engineers time and mental energy to manage the bare metal setup vs the cloud managed offering. Its penny wise and pound foolish.
I am a one-man start-up, well, trying to be for some years now, and I run a similar bare metal setup as the one above. Haven't touched it in 142 days and it costs next to nothing vs. the $200/month that I couldn't afford even if I wanted.
Again, maybe the word 'start-up' has too many meanings. Sure, once you have 1,000+ paying clients you will be able and even you will need to rely on cloud infrastructure, but 90+% of start-ups never reach 1,000+ paying clients. And again, it's not that complicated, pretty much everything is a Helm chart, and when you are merely trying things out, not even close to product-market fit or monthly recurring revenues, you can afford to have the cluster down for days on end: there is no one to care.