1. People don't design schemas to be sharded, although many gravitate towards a common key, e.g. user_id or country_id or tenant_it or customer_id. Once that happens, sharding becomes easier.
2. Postgres provides a lot of guarantees that are tricky to maintain when sharded: atomic changes, referential integrity, check constraints, unique indexes (and constraints), to name a few. Those have to be built separately by a sharding layer (like PgDog) and have trade-offs, usually around performance. It's a lot more expensive to check a globally enforced constraint than a local one (network hops aren't free).
3. Online migrations from unsharded to sharded can be tricky: you have to redistribute terabytes of data while the DB continues to serve writes. You can't lose a single row - Postgres is used as a store of record and this can be a serious issue with business impact.
We're taking increasingly bigger bites at this apple. We started with basic query routing and are now doing query rewrites as well. We didn't handle data movements previously and now have almost fully automatic resharding. It takes time, elbow grease and most importantly, willing and courageous early adopters to whom we owe a huge debt of gratitude.