Usually, it is replicating an on-prem Active Directory environment into Azure. It is usually tied with generic email access and SharePoint Online access and building out provisioning for that. There typically is some sort of synchronization tool that is sometimes used in addition to or as a substitute for the typical Microsoft suite. So, it just depends upon the customers and how they're getting that information up there.
In terms of version, it tends to be a mixed bag. It just depends on the client environment and factors such as the maturity and the rigors of change management. Sometimes, it just lags, and we've dealt with those types of situations, but more often than not, it is more of a greener field Azure environment and tends to be the latest and greatest.