These larger ones are fully using the PlanetScale SaaS, but they are using Managed -- meaning that there are resources dedicated to and owned by them. You can read more about that here: https://planetscale.com/docs/vitess/managed
All of the PlanetScale features, including imports and online schema migrations or deployment requests (https://planetscale.com/docs/vitess/schema-changes/deploy-re...) are fully supported with PlaneScale Managed.