Server setup is quite simple if you use MS SQL Server. As for creating a database and tables, you usually do this only once. The whole point of the database is that the data is persistent, so if there is a chance that the database will not exist, you either have serious stability problems, or b) there is no need for a real database.
Designing a database, tables, and procedures is an entire component of the software development process. When I do this, I usually keep all of my creation scripts in the original control. Once created, you will write the program in such a way that it assumes that the database already exists. Checking the connection is one thing, but a program should never think that there is no database at all.
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