As per https://docs.microsoft.com/en-us/azure/sql-database/sql-database-advisor-portal create/drop indexes can now occur automatically.
Extracts from https://docs.microsoft.com/en-us/azure/sql-database/sql-database-advisor
Create Index recommendations
Create Index recommendations appear when the SQL Database service detects a missing index that if created, can benefit your databases workload (non-clustered indexes only).
Drop Index recommendations
Drop Index recommendations appear when the SQL Database service detects duplicate indexes (currently in preview and applies to duplicate indexes only).
As it’s currently only non-clustered and duplicate indexes, the potential issues when a change is made should be limited. It is indicated that the recommendation will be reverted if performance was negatively impacted by the change. What is not currently clear, is what period of time or amount of monitoring will need to pass before a negative performance change will be reverted.
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