Nowadays I hardly do any SQL Server Setup anymore, customers usually provide a SQL Box as they wish to have by own policy. I mostly do some fine tuning around CTFP, check max Memory, maxdop etc. for feasibility. I spend much more time analyzing existing DB access patterns during times of slow running Jobs / Queries and have a look at a few Design things I can modify like FileGroups and Number of Files in each.

But I did set up MSSQL Servers by DVD, ISO, System Center Service Manager Templates, Powershell and I still am looking for a potential future customer which might see use of centralized DSC for deployments at scale. I've seen some demos with IIS providing such configuration.