Not having a title is most definitely not ideal but in some cases is nothing more then a minor added expense.
Example: the yellow 40 I recently purchased did not come with a title signed into my name. The owner did have a NC title that was signed to him form the previous owner...which could've been put into his name and then signed to me. This would've cost a few hundred bucs and time. The option I chose was to pay a couple hundred less for the truck but without a title in my name.
There is a detailed process to get a title in these circumstances...starts with a surety bond. These usually cost 100.00 for the trucks we are dealing with and serve the purpose of removing liability from the DMV if there is a an issue with the vehicle (stolen, title lien, etc.). If the vehicle in question is old enough to not require emissions and/or safety inspection then the process is usually just the surety bond, a couple forms, bill of sale and a trip to the plate agency with $.
This process can definitely be complicated if the vehicle was never titled in NC, etc, etc. You would also not want to proceed with this route if you have any reason as to feel less than 100% confident of the sellers legal ownership of the vehicle...when dealing with folks whom you have no prior relationship/ connection to then this will likely always be a question.