On residential connections it’s a bit pain in the rear, but if you get VPS (or something similar) it’s perfectly manageable. You just need to maintain stuff properly, like having proper DNS records, and occasionally clear false positives from spam lists. The bigger issue is to have proper backups and precautions, I’ve hosted my own emails for over 10 years and should I lose all the data and ability to receive new messages it would be a massive personal problem.