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PostgreSQL 18 introduces a native `uuidv7()` function, enabling time-sortable UUIDs as primary keys without extensions. Using UUIDv7 with Ecto requires three specific changes: setting `primary_key: false` on the table and manually adding an `id` column with `default: fragment("uuidv7()")` in the migration, then disabling `autogenerate` on the schema's `@primary_key` attribute (so Ecto doesn't override the DB default with a UUIDv4), and finally enabling `read_after_writes: true` so the generated UUID is returned and populated on the struct after insert.

Using UUIDv7 with Ecto and PostgreSQL

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