Few people do.
And even those that actually do truck things (read: haul shit) could have smaller, yet stout and pedestrian-safe trucks.
I hate my 2500 but it’s one of three offerings with a diesel for towing. I tried really hard to make something like an Isuzu NPR work since it is shorter and I can actually see what’s in front of me.
Oh and just putting a diesel in a small truck does jack shit as they don’t change the suspension of axles for the needed ratings. Diesel is just a part of a bigger picture.
I would take a van but gooseneck/fifth wheel hookups don’t work.