This is the reason I manage SQL Server on a VM in Azure instead of their PaaS offering. The fully managed SQL has terrible performance unless you drop many thousands a month. The VM I built is closer to 700 a month.

Running on IaaS also gives you more scalability knobs to tweak: SSD Iops and b/w, multiple drives for logs/partitions, memory optimized VMs, and there's a lot of low level settings that aren't accessible in managed SQL. Licensing costs are also horrible with managed SQL Server, where it seems like you pay the Enterprise level, but running it yourself offers lower cost editions like Standard or Web.