Some pain points on my mind:
- Dealing with regulatory requirements. Especially in financial institutions.
- Skills. You can have good engineers who manage your on-prem infrastructure, databases, security, etc. It doesn't mean that they are or will be able to configure your cloud.
- Managing cloud costs. Some organizations plan infrastructure budgets in a way that is not compatible with the cloud...
- Performance problems with some quite custom solutions. For example, we had some problems with Oracle and EBS disks. @Vivek Desai S3 example is also quite interesting.