As Knuth said,
We should forget about small efficiencies, say about 97% of the time: premature optimization is the root of all evil.
The need to use a profiler should be left for extreme cases. The engineers of the project should be aware of where performance bottlenecks are.
I think "premature optimisation" is incredibly subjective.
If I am writing some code and I know that I should be using a Hashtable then I will do that. I won't implement it in some flawed way and then wait for the bug report to arrive a month or a year later when somebody is having a problem with it.
Redesign is more costly than optimising a design in obvious ways from the start.
Obviously some small things will be missed the first time around but these are rarely key design decisions.
Therefore: NOT optimising a design is IMO a code smell in and of itself.