I build websites using HTML, Bootstrap or Wordpress. Note that I didn't say I design websites. There are many designers in the world who are more suited to design than I. Generally, I take an existing design(theme) chosen by a client and then alter it to suit their needs. If I was to use an analogy, it's similar to the difference between an architect and a builder. A client can either bring their own favoured design or I can show them some that suit their needs and we can go from there. It is my experience that if the final result is not original by design it will become original by evolution.
Most hosting is done on a server that is also hosts other websites. I do this with some sites to keep costs (for instance I host a few non-profits for free) but in general I prefer to have one server per site. This allows me to focus that server on the sites needs. For instance, if an htaccess file is needed then Apache with an NGINX cache (or Lightspeed) might be used. A high traffic site could be given more resources and a static site wouldn't need the overhead of a database.
In all projects the longest amount of time is spent in the maintenance and this is no different with websites. I scan them every five minutes to make sure they are live, apply updates to the servers and security updates to the sites themselves, flush the caches and keep backups. Occasionally this means rebooting the server but not very often. And, as I use Linux servers on Linodes network, rebooting only takes a minute and restoring from backup around five. I aim for 99.999% up time (around five minutes down a year).