You could. But then you’re also building from scratch HA failover, backups, replica management, monitoring, etc - cloud vendor managed RDBMS come with lots of niceties. All of which are possible to set yourself. But a hassle, and difficult to make bullet proof.
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I'm sorry, I'm sure you've considered this, but why couldn't you create a bare VM with Postgres vCurrent installed?
You could. But then you’re also building from scratch HA failover, backups, replica management, monitoring, etc - cloud vendor managed RDBMS come with lots of niceties. All of which are possible to set yourself. But a hassle, and difficult to make bullet proof.