I think mbtiles are being phased out for pmtiles because no DB required and can be served from static storage like R2/S3 (with a worker but hopefully the worker part goes away and they support byte offset requests soon)
You don't need a database to serve mbtiles. If you're deploying PMTiles somewhere that doesn't support byte offset requests, then they don't really have much advantage over mbtiles.
That depends what you mean by needing a database. MBtiles files are SQLite database files, so you need a SQLite process running somewhere to extract the requested tiles.
To answer the question: somebody needs to do the initial work and it's a further moving part that needs to be kept running (as the other responses point out such a distribution would likely use PMTiles as a container format). Given the current finances and staffing of the OSMF likely not top priority.
[1] https://registry.opendata.aws/osm/