Our clients at Wubur (the web development company
I partially own) go for a variety of solutions. Sometimes we have clients that want a website made completely from scratch, and other times our clients want premade templates that are just heavily customized. It all depends on the client, but a lot of times our main focus is on backend logic & code. For example, a client may pay $500-1000 for some basic web design, but pay $3000 for a management portal - to help them organize their properties or tenants, products, etc... whatever it is they need their custom online software for.
When it's from scratch we usually sit down and talk about general look and feel before specifics such as colors, logo, etc.
We'll discuss "one page" options, multi-page websites, the differences between responsive and mobile-specific web pages, and much more. We start by creating basic elements such as a fixed header, 2 column display, a grid layout section, calls-to-action banners, etc. Once we establish a few types of elements & section types the client can help us understand their vision and preferences a bit more. Then we can bring it all together and assemble an actual full homepage... and then focus on content, images, colors, etc.
When we use templates we usually jump right into colors so we can customize the template a bit before showing the client. They're obviously aware it's a template, but a lot of clients struggle to truly appreciate a premade web page if the colors are completely different. This helps them envision the final result. Then we can move sections around, create our own custom sections, and start building out the content.