Usually it uses a database. But using the server to insert content in different languages could be done without a database. Blocks of body text could be stored in files. Smaller bits of text content such as menus and buttons stored in arrays, etc.
I’m guesing from your other topic that you are looking to avoid databases because of perfomance concerns. Really I would want to be sure that a database is the real bottle-neck before making life difficult by avoiding such a useful tool.
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