First of all, any clinician that says everyone with "X" needs to do "Y" 100% of the time, with 100% accuracy... That's not patient-centered care, nor is it evidence-based.
Second of all, there are waaaaaay too many other factors that affect blood sugar besides carb intake to think for a second that counting every single carb that goes into our body will make a significant difference in blood sugar management. Here's just a snippet of other things that can affect blood sugar:
Fat intake (and types of fats)
How we feel about our diabetes
How we feel about ourselves
Thirdly (that's a word, right?), it's crucial to consider how this emphasis on counting carbs with the utmost perfection might be affecting our mental, emotional, and relational health.
ALSO! who are we to expect to know the exact amount of carb in a food? Even if you carefully measure each food you eat, the database you're pulling the carb count from can't account for THAT EXACT FOOD you're measuring. And food labels aren't 100% accurate (see sources below).
Finally: Diabetes care needs to be individualized. If you're new to a carb ratio, I'd be willing to bet that googling the carb count of a food now and then is going to help you have a bit more stable blood sugars. If you're recently diagnosed and on metformin, carb counting is wildly unnecessary. Diabetes care is NEVER one-size-fits-all.
So, no. You do NOT need to count every carb that goes into your body. Let's consider some other factors that are influencing your blood sugar and health and have some self-compassion instead.
(Also, if counting every single carb that goes into your body is working for you and not causing you mental anguish, well then -- shit! -- keep doing what works for you, my friend.)