Mastohost is doing a REALLY good (if incomplete) job of Saasing Mastodon, and the software itself is getting easier to deploy every time i convince myself starting an instance is a good idea. and a lot of the issues raised frequently are already on the roadmap (as was demonstrated elsewhere in the thread)
The good thing about the fediverse story is its open and incomplete; we have the ability to shape how it looks, and honestly, i think the letter and spirit of the technology is incompatible with thousands of users per instance under voluntary moderation.