For people using self custody, how do you actually spend crypto in real life?

I have been trying to figure this out lately. What do you do in real life when you want to spend money that you mostly keep in self-custody? Do you usually move it to an exchange first and change it to fiat, or do you use a card or some other way? I get why people want to keep their money in their own hands for control, but it seems like there are always extra steps when it comes to using the money. I'm interested in how people do this in real life without making things too hard or losing too much ease.