My recent poll What alert monitoring do you use? showed 25% of the 58 respondents to bravely state they had no MySQL monitoring. I see 1 in 3, ~33% in my consulting so this is consistent.
There is no excuse to not have some MySQL Monitoring on your production system. At the worse case, you should be logging important MySQL information for later analysis. I use my own Logging and Analyzing scripts on every client for an immediate assessment regardless of what’s available. I combine that with my modified statpack to give me immediate text based analysis,