Have you worked with SQL manually or only through ORM?

I have worked both directly with SQL and through ORM.

Direct use of SQL is useful for complex queries, performance optimization, and when precise control over queries is needed. For example, writing complex JOINs, subqueries, or index optimization.

ORM (such as SQLAlchemy in Python) simplifies working with the database, allows writing code in a programming language, automatically generates queries, and manages relationships between tables. This speeds up development and reduces the likelihood of errors.

In practice, I often combine both approaches: main work through ORM, and for specific tasks — direct SQL queries.