It's very different than Nomad! The basic model is direct "machine" management with very little orchestration. Machines are kind of like allocations, but more permanent.
Some machines operations are slow, some are fast. Create is slow, update is slow. Start and stop are fast. Future "suspend" and "resume" are very fast.
For the regions case, people use these by having a couple of machines per region they care about. Then they start and stop as needed. A stopped machine can be migrated between nodes, but we ensure it's ready to start quickly if we do that.
Some interesting things happen with this model. Create is slow, but we are able to make it fast _sometimes_ because we can target creates at hardware that already has the rootfs cached.
Updates don't work like nomad, we update machines in place for a rolling deploy. This lets us do things like pull an image in parallel, then stop the machine, update, and restart very quickly.
We're also doing things differently with health checks. We may not wait for an active health checks before sending a machine an HTTP request. Many workloads don't even care about health checks, they just want a VM running and streaming logs back as fast as possible.
There are features I could ask for in Nomad to do what we'd need, but they'd make it not Nomad. :D