What it asks for. The control asks you to manage the whole life of system accounts: define which account types are allowed, assign account managers, set criteria for group and role membership, approve and document who gets what, and create, change, disable and remove accounts according to policy, with regular reviews.
In practice. This means a joiner, mover and leaver process driven from HR data, ideally automated through an identity platform, with named owners for privileged, service and shared accounts. Auditors look for approval records, periodic access review evidence with sign-off, timely disabling of leavers and reports of inactive accounts. CIS Control 5 and ISO/IEC 27001 user access management controls cover the same ground.
Common gaps. Service and shared accounts without owners, access reviews that are rubber-stamped, and movers who keep old access are the most common findings. Accounts in cloud and SaaS tools outside the central directory are often missed entirely.