B2B and integrations will be even worse. Almost no project on Nostr has the money to fund this infrastructure or the will to as long as they don’t notice the effects.
The few that do, are not willing to fund this infrastructure, ask me how I know.
Almost every CDN service does the things you have listed, and the other option is build your own which is really expensive.
Or host media out of a basement/VPS and accept that it will be pretty bad and still expensive for the bandwidth.
In the end, there are tradeoffs, and the majority of the people do not want to tolerate the cost and impact of changes.
And out of the concerns you have listed, only a subset of them apply to a media host. (as I specified in my original post)