Yes, the app uses Azure Event Subscription notifications to enable real-time synchronization. When files are uploaded directly to Azure Blob, the app triggers an HTTP callout to a Salesforce REST endpoint, creating file records in Salesforce with any relevant metadata.
P.S. Discover Azure Integration, the easy way to upload files from any Salesforce record to Azure. Find it on AppExchange: https://appexchange.salesforce.com/appxListingDetail?listingId=c9e71bd6-5bab-4182-a461-b82d4f971183