I recently helped a friend change a tire on a ~2014 F-150. The spare tire is under the bed of the truck, and we discovered to access it you unlock an access plug from the rear bumper, stick a rod in the hole (heh), and crank it to lower the tire down on a cable from a winch-type assembly.
I never knew that was a thing, how long have pickups been like that and do all pickups have spare tires on a cable/winch?
My 2013 Toyota Highlander has a similar system.