This creates, what I call the "Work of Worry."
The burden of ensuring that every aspect of your job - human resources, budgets, customer service, reliability, security, and strategy are optimized requires constant vigilance and daily management attention.
For example, each night before I go to sleep, I mentally run through every one of my direct reports and ask myself what issues are unresolved, what projects are going off track, what budgets are at risk, and what strategies need adjusting. I make a list and then sleep on it. In the morning, when I'm refreshed, I send out email and schedule meetings to address everything on the list.
This means that no issue remains unaddressed for more than a day. There may be a multiweek process needed to resolve some issues, but at least that process is initiated in a timely way.
When leadership is not a job, but a lifestyle and every aspect of the organization's performance becomes the responsibility of the leader, the work of worry can be intense. It can become challenging to balance responsibility/anxiety with family life, free time, and maintaining a positive mood.
So if you are thinking that your leader's work is not always visible, consider the time that is spent on the "Work of Worry" and ensuring that the organization does the right thing, all the time.