Most Lexus vehicles in Australia are hybrids, and the hybrid is where the carbon problem lives — not where most owners expect it.
A Lexus hybrid runs high rates of exhaust gas recirculation to keep combustion temperatures down. The intake manifold carries both fresh air and recirculated exhaust gas, so carbon and oil gradually silt up the manifold passages, the EGR cooler and the valve. The engine also spends much of its life switched off or running gently, so it never gets hot enough to burn any of it away. A rattle on cold start is the classic sign, and it is very often mistaken for something more serious.
If you have a petrol Lexus — an IS, RC or LC — it depends on the engine. The IS 250 (2005–2015) injects straight into the cylinder, so it is intake valve carbon instead. The IS 350, IS 200t, IS 300, petrol RC and LC 500 also spray fuel onto the valves, so they rarely need that work.
And if you have an LX450d or LX500d, you have a diesel with a particulate filter, and everything on the diesel side applies.