Doesn't mean, it significantly complicates state. Because the place that stores it (say, your bare metal machine with your database) is now the bottleneck.
None of the autoscaling solutions presented in the post address the database issue either.
I agree that in general the database is always going to be your bottleneck and autoscaling appservers is generally bullshit.
But let’s assume your DB is fine and you do actually need to scale appservers beyond what your provisioned capacity can allow, you can trivially spin up VMs at AWS or your provider of choice, Wireguard to your “VPC” at your bare-metal provider (or just SSH tunnel the ports) and run your appserver binary/container/etc on it.
Hell in a pinch you can do the above with your dev laptop and serve traffic from it. It will work and your customers won’t even be able to tell.