John McCormack shows how you can set up database mail from an Azure SQL Managed Instance:
It’s not too difficult to set up database mail for Azure SQL DB Managed Instance in comparison to SQL Server (on-prem or IaaS) however there are a few extra things to consider. This post will describe how to set up database mail for Azure SQL DB Managed Instance. I will use Sendgrid as the mail provider but you can follow the same steps for any other mail provider or your company’s smtp server.
Before I go on, my personal opinion is that including database mail is a massive feature for Managed Instances. The lack of DB Mail on Azure SQL DB Single Database or Amazon RDS is a major blocker to PaaS adoption. Now with Managed Instance, we can have PaaS and database mail.
Read on for the instructions. There’s a little bit more than what you typically would need to do on-premises, but just a little bit.