I've both used module-starter, and have copied the files from another project, and substituted the name and version.

Both work fine, though Module::Starter was a bit nicer to use.

Why is module-starter so complex?

As a user, this question doesn't bother me. I don't find it complex to use. As long as it's maintained, why bother about internal complexity?

Why is module-starter so inflexible?

That doesn't bother me either. I don't need more flexibility from it.

Why does Module::Starter do so little?

Because otherwise it would be even more complex? Again, it does enough for me.

So, after reading your questions, is the starting of modules an actual concern of yours? How often do you start a new module?

I don't want to discourage you from improving things, but from our CB discussions I get the impression that you often get stuck in small details that wouldn't bother me for more than a minute. If you draw satisfaction from that style of development, then you're fine. I know I enjoy getting results much more than beating small points to death.