I like to think of the format and the drawing as laying on top of each other transparently. Items on the format will "show through" to the drawing.
Since the actual format is being loaded every time the drawing is opened, any changes to the format will be instantly visible on the drawing. The exception to this is tables.
Tables contained in the format are actually copied to the drawing at the time the format is applied (or the drawing is created). The format's actual tables are not visible in the drawing beyond what was initially duplicated.
Future changes to format tables will not automatically appear. To get them to appear, you have to re-apply the format. When you do so you will be prompted to either replace all the existing tables (with the new ones on the format), keep all the existing table + the new ones, or just keep some of them + the new ones.