It exposes the raw savedata for research (before/after diff), and allows direct/indirect modifications for everything about the save file even if it is undocumented.
SWSH/PLA/SV save files are stored as a collection of savedata objects (uniquely identified by a 32bit FNV-hash key), and each object has embedded metadata about the object (shown in the block detail list label). The dropdown allows you to select any savedata block object; the program will show the 32-bit key if it does not have a name assigned (manually identified and hardcoded by PKHeX's maintainers). If a block is a recognized object, you can see properties on the right side to change as you see fit. Otherwise, it will show the raw data similar to a hex editor, which you can export and modify yourself, and import when finished via the buttons on the left.
There are some things that PKHeX doesn't edit, like fashion or importing past distribution raid data. But you can import these blocks via this interface.