The Internet of Things is large-scale by nature. This is not only manifested by the large number of connected devices, but also by the sheer scale of spatial traffic intensity that must be accommodated, primarily in the uplink direction. To that end, cellular networks are indeed a strong first mile candidate to accommodate the data tsunami to be generated by the IoT. However, IoT devices are required in the cellular paradigm to undergo random access procedures as a precursor to resource allocation. Such procedures impose a major bottleneck that hinders cellular networks' ability to support large-scale IoT. In this article, we shed light on the random access dilemma and present a case study based on experimental data as well as system-level simulations. Accordingly, a case is built for the latent need to revisit random access procedures. A call for action is motivated by listing a few potential remedies and recommendations.