The Atlantic Multidecadal Oscillation (AMO), characterized by basin-scale multidecadal variability in North Atlantic sea surface temperatures (SSTs), has traditionally been interpreted as the surface signature of variability in oceanic heat convergence (OHC) associated with the Atlantic Meridional Overturning Circulation (AMOC). This view has been challenged by recent studies that show that AMOC variability is not simultaneously meridionally coherent over the North Atlantic and that AMOC-induced low frequency variability of OHC is weak in the tropical North Atlantic. Here we present modeling evidence that the AMO-related SST variability over the extratropical North Atlantic results directly from anomalous OHC associated with the AMOC, but that the emergence of the coherent multidecadal SST variability over the tropical North Atlantic requires cloud feedback. Our study identifies atmospheric processes as a necessary component for the existence of a basin-scale AMO, thus amending the canonical view that the AMOC-AMO connection is solely attributable to oceanic processes.