What if my Database performance requirements are very high in terms of IOPS? Should I still be using Azure SQL PaaS?

Azure SQL as a service offers premium tier that offer DTUs that can scale to 4000 and also provide 4 TB of Storage capacity. Azure SQL also supports an optional Active Geo replication that keeps data replicated to an alternate geography. Partners can create multiple copies of the database through Geo replication. This is an asynchronous replication.

Active Geo replication must be within the same subscription.