IO performance for your Managed Instance may not be what you were expecting. Typically when we create databases, especially when working in the cloud, we create the databases pretty small. However, this can be a problem with Azure SQL Database Managed Instance. The performance that’s assigned to your databases which are hosed in Managed Instance will depend on the size of the database when you first create the database. This means that you’ll want to create the database at the largest size possible (1TB currently) to get the best possible performance from your managed instance environment.
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