Thing is, I’ve
been doing this since before Exchange Online, I know.
People used a few different groupware solutions, worked with bespoke IMAP installations on Linux servers, or (the vast majority) had on-premises Exchange servers running locally. It all required lots of tech wizardry, tinkering, duct tape and hope.
It was a long while before we had turn-key solutions, and you needed actually knowledgeable folks running your IT operations, and nothing was as fully integrated or cheaply available as Exchange Online.