nobody does these things manually

Don't we all wish!

Uhm, but at least hopefully folks have at least mostly automated the procedures.

So, yeah, e.g. much of my rather complex cert architectures, and those I manage, have generally, as feasible, automated the heck out of 'em. But that doesn't mean absolutely everything is fully automated. Some things it's still more efficient to do (semi-)manually than do all the code, etc. to fully automate - some of those edge cases the ROI just isn't there for making it 100% automated, yeah, often the optimal, in e.g. operating costs, is more like about 99.75%+-.

So, e.g. I've got programs that, given appropriate arguments, will get certs - including complex SAN certs with wildcards, and many domains - even lots of certs in one single command. Also have programs that semi-automate a lot of the installation of such certs. But alas, not everything is fully automated. Why spend a week coding up something that'll save 180 seconds every 80 days? On the other hand, a few days coding up what saves many days or more of work/time per month - and cuts it down to minutes or less - that was all done long ago.