Poor database performance can lead to missed SLAs, delayed releases, customer dissatisfaction, and lost revenue. Microsoft has enhanced PostgreSQL on Azure, transforming it into a fully managed platform that meets enterprise demands. Azure Database for PostgreSQL and the new Azure HorizonDB offer significant performance improvements, with HorizonDB being three times faster than self-managed PostgreSQL. The PostgreSQL extension for Visual Studio Code integrates performance management into development workflows, providing tools for managing PostgreSQL throughout its lifecycle. Key features include a server metrics dashboard that displays performance indicators, Azure Advisor recommendations for actionable insights, improved query plan visualization, and AI-assisted query analysis. The extension also enhances schema design and query formulation experiences, ensuring secure and governed interactions with PostgreSQL. Azure HorizonDB is in public preview, designed for AI-native workloads. These advancements aim to reduce friction, enhance clarity, and enable faster actions for enterprise teams managing PostgreSQL at scale.