It can really be anything. Sometimes they’ll go to the line with a “check with me” call. Other times he might audible out of a run because the line is stacked or vice versa. Or sometimes you’ll just see him nod to a certain receiver to adjust that one route.
The days of offenses just coming to the line and running whatever play was called in the huddle are over. If you think about it, what makes the most sense is having an offense that can adjust instantaneously to what the defense is doing. While it’s hard to find a quarterback and set of weapons who can all get on the same page to execute this kind of offense, once you can do it there’s no going back.