Only those that you give it to have them, as they do not come with any models by default. This means that only i case of characters with access to the armoury it even has to be considered, as they are the only who even can have them.
If you have them to such a model, then yes, at least in a tournament environment they always would have to be modelled. In games among friends things may be different though.
They dont have to be modeled, you just need to make sure you remember counting them cause usually people forget that they even have em (I did a couple times). As far as I know only dicapitator has g.tallisman to start with, for everyone else you need to pay.
Modeling gruesome talismans can be quite simple to model. All that the talisman needs to be is a necklace with a body part, a bracelet with a finger or two on it, or just a charm dangling off of the character's belt. It can almost be anything you want it to, since the description of it in the codex is very vague. Be creative. Have fun with it.
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