Not the author but it likely means running automated UI tests in the sim, yes. This involves running the app and programmatically selecting and sending interaction events.
Your previous experience was probably the agent running regular unit tests, which obviously don’t need ui environment, but mostly *do* need an iOS runtime, which is why it needs to boot the simulator.
An idiosyncrasy of the way unit tests are executed in Xcode is that they run from the actual app deployment target, and so while running unit tests you’ll also see any app initialisation and background tasks running at the same time. It’s quite a good idea to use compiler directives or launch arguments to disable the usual app setup in the App or App Delegate. Why this isn’t a built in option is beyond me, but it’s definitely confusing behaviour when you’re just running isolated tests!