No, you are unlikely to feel out of place for not speaking Urdu, especially in cities and tourist regions where English is widely understood.
English usage in urban centers
English is commonly used in hotels, airports, and by many professionals in urban areas. Road signs and official documents in major cities are often bilingual.
Rural communication
In smaller towns and rural areas, Urdu or regional languages are more commonly spoken. Even so, basic communication through simple English, gestures, or translation apps usually works.
Local interaction
Most locals are patient with foreign visitors. Language differences rarely prevent daily travel activities within established tourist routes.