Pretty much what
@Leon Loco said. I'm in Texas and if you don't take the MSF course, you have to take a written test on the computer for a permit. You also have to be 18 years old. Then to be fully licensed, there is a road test, similar to what you do for your car license. I didn't do it this way but one guy I know said he had to do some stuff in a parking lot then they went out on the road with the trooper following in a car.
If you take the MSF course, you get classroom and practical instruction on the bike. then there is a written test in the classroom and you do your road test in the parking lot with other people, basically, demonstrating that you learned what you were taught in the course. There is a Trooper there who directs it all and grades you. Once you pass, you get a voucher you can take to the DMV, where you pay some more money and get your license. Around here the MSF course is about $185.
Most people use the MSF course now, simply because it's most convenient.