I played in a heavily sequenced, drum machine/synthesizer pop band back in the mid 80s.
We relied heavily on MIDI to generate our sound live.
The piano roll analogy above is exactly correct. In fact, one of the views in Cakewalk (at least older versions of it) was called piano roll.
It also contains note on, note off, duration, velocity (how hard you pressed/struck the key/pad), as well as control information (patch names, patch changes, volume starting point and up/down, effects parameters, etc.).
We had both full synths (Yamaha DX7's and DX5's, Roland JX8P and D50, Korg Poly800) plus modules like the Proteus and Roland MT32. Our MIDI rig was pretty sophisticated for the time (not so much now) as we used a JLCooper MIDI patchbay/router to send receive signals and redistribute them from two MIDI ports on our PC.
Greek?
Let's try it this way. I played bass and sometime guitar. Another guy played the keys and we had a singer - plus the computer/MIDI rig.
The MIDI signal did lots. When we first walked onto the stage, I pressed the space bar on the computer - which started our first song. The drums were drum machine, the bass line from one of the MT32 channels. Horns came from the proteus, the keyboard player was playing stacked sounds from the DX7 and the D50. All of the patch changes and volumes were controlled by the computer and happened right on cue.
The guitar started with a distorted rhythm with crunchy bar chords, Once the vocal started it went to that 80s, ultra clean with loads of chorus tone. The MIDI file instructed the processor to change patches and adjusted the volume down. I didn't step on a pedal, the computer made the change for me.
When the verse ended there was a short guitar solo, the MIDI file instructed the patch change to a lead tone, with a little reverb and volume boost. As I played the last note the MIDI file turned the volume down and the reverb up slightly, then switched the patch back to the clean tone just as I hit the notes for the second verse.
It's not "unlike" playing to a pre-recorded track - except take away the DX7 and you lose a keyboard track, because the MIDI file was actually playing a DX7 that was sitting on the stage. If I were to walk over to that DX7 and pull it's volume lever down, then the sounds would've disappeared from the mix.
With the guitar, I still played the guitar, but the MIDI file was in total control of the guitar rack processor, which was a multi-effect unit. So it controlled the guiatrs volume and patches, including distortion.
We programmed all of the information, in detail, into the MIDI sequence during rehearsals. I never stepped on the wrong pedal or turned up too loud (or not enough) for solos. The MIDI track did all of that for me, precisley the same every time.
This was done on a IBM286 running Cakewalk DOS 5.1 - before Windows even existed.