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It basically patches/intercepts the winapi text drawing calls, and does its own drawing instead. There are some hints how it works here https://github.com/snowie2000/mactype/wiki/Secure-Boot
I played around with this back when I used Windows, maybe 5 years ago. It made text look better on the laptop screen (high dpi) but worse on external monitors (low dpi). That made sense because Apple doesn't sell anything with a low dpi display, but Windows still needs to run care about them, so it does a lot of extra stuff like font hinting to make rendering look good as dpi scales down.