What sign-off looks like on Free and Standard, where the built-in feature is not available.
If you have searched for how to get a Confluence page formally approved, you have probably found Atlassian's documentation for its approvals feature and then discovered it does nothing on your site. That is not a configuration mistake. The feature is gated by plan.
Atlassian's own documentation is unambiguous: "Approvals are available only on Premium and Enterprise plans." It also notes that "Approvals are supported on pages, but not on live docs or blog posts."
Where it is available, it is good. You start an approval from the content status menu, approvers respond from a banner below the byline, and the activity log records who was asked, who approved or requested changes, any comments and when. Space admins enable it under Status and approvals in space settings, and can optionally require approval before publishing. Required approvers are capped at five, and both requesting and responding need edit permission on the page.
If you are on Premium or Enterprise, use it. Nothing below will beat a native feature you have already paid for.
Two things, neither of which is really an approval.
Content status. You can label a page - rough draft, in progress, ready for review. It is useful and it is visible, but a status is a label, not a decision. Anyone with edit permission can set it, nothing records who set it or why, and nothing distinguishes "someone marked this approved" from "the right person approved it on the ninth of October".
Comments. The honest default for most teams. Someone writes "approved" in a comment and everyone moves on. It works until you need to answer the question an auditor, a customer or a new starter eventually asks: who signed this off, and when? Scrolling a comment thread is not an answer, and comments can be edited after the fact.
There is no supported way to turn on the native approvals feature on Free or Standard. The choice on those plans is between living with status and comments, upgrading the whole site, or adding an app.
Weigh it against the alternative honestly. Upgrading an entire Confluence site from Standard to Premium to get approvals is a large per-user cost increase for one feature, and Premium includes a great deal you may not need. If approvals are the only thing you are missing, that is an expensive way to buy them.
Disclosure: I build one of the apps in this space. Page Sign-off puts an approval item in the page byline: request sign-off, choose how many approvals are needed, and approvers approve or request changes with a note. The decision and who made it are recorded on the page rather than in a comment thread. It works on any Confluence Cloud plan, including Free and Standard, it runs entirely on Atlassian Forge so no page content leaves your site, and it is free with no user limit.
It is deliberately small. It does not do space-wide required approvers, approval before publishing, or multi-stage workflows - if you need those, that is what Premium's built-in feature and the larger paid apps are for.