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Changes who can see it really.
The PiHole resolved it all to 1.1.1.1, having stripped out blocked traffic, this just changes who does that resolving and stripping step. You'll still have someone doing the resolving for you.
I've just been and checked on my nextdns account, and I'm using far more than I had thought, like ~180,000 queries in 4 days (most to ubnt.com & nest.com).
Looking at that, I'll be miles over their cap pretty fast, which isn't an issue at the second, and for $24 per year for not having to look after a pihole is kind of tempting. I'm also slightly tempted to run the pihole myself, with aggressive caching, and send queries through to nextdns to resolve as a second level of blocking. I'll have think about it a bit further now.
I've just ditched my pihole, and switched over to https://nextdns.io/ following a mention of it by VB.
Quite liking it so far, and I think that I'll just slip under it's monthly limits. Free's up a pi v3 for something else (time lapse photos initially, but likely I'll switch it over to Octoprint for the Ender 3 Pro that I just picked up)