Good day,
You speak about Azure SQL and use the tag azure-sql-database. Therefore, I assume that you means Azure SQL Database, which is a database service. it is not relevant how Microsoft provides you the service. Microsoft can use any solution which they find best for them in order to host the service, including using any operating system which they want. Moreover, even if we/they will provide the current architecture behind the scenes then no one guarantee that it will stay the same tomorrow and no one will inform you if it is changed in public channels probably.
You need to choose if you want to use database level service (Azure SQL Database) or server level service (Azure SQL Managed Instance) or hosting level service (Azure Virtual machine - in this case you can control the OS)