Earlier quoted context omitted.
Postgres 17 tremendously improves vacuum performance
Vacuuming is a design decision that may have been valid back in the day, but is really a ball and chain today. In a low-resource environment deferring work makes sense. But even in low-resource environment the vacuum process would consume huge amounts of resources to do its job, especially given any kind of scale. And the longer it's deferred the longer the process will take. And if you actually are in a low-resource…
You run VACUUM often enough that you never need a VACUUM FULL. A normal VACUUM doesn't require any exclusive locks or a lot of disk space, so usually you can just run it in the background. Normally autovacuum does that for you, but at scale you transition to running it manually at low traffic times; or if you update rows a lot you throw more CPUs at the database server and run it frequently.
Vacuuming indices is a bit more finicky with locks, but you can just periodically build a new index and drop the old one when it becomes an issue