32X Doom tried to be like the original PC game, but it was rushed through development as a launch title with a small team. The result is.....tragic. Specifically: half the maps were missing, both the game window and resolution are reduced to get playable framerates, the original soundtrack famously sounds a bit like a farts at times, several visual effects like parallax texture scrolling, transparency, and lighting effects are gone. (there's a room in E1M5 near the end that the lights alternate between on/off, but the monsters on 32x are always visible.) This also means no invisibility power-up, or Spectre monsters.

My favorite jank is after the credits when you finish the game, it dumps you into a fake DOS prompt. It just shows C:\DOOM> and you are unable to interact with it in any way.

It notoriously has the best worst audio from any doom game. Look up at dooms gate 32x to see what I mean.

Fair to say only the Gameboy port was worse. Famously awful port

Based on what it says on the Romhacking page https://www.romhacking.net/hacks/6269/

"Verified as working on Kega Fusion 3.64, a Model 2 Genesis + Model 2 CD + launch 32X, a CDX + 32X, with a NeoFlash NeoMyth MD and the V1 Mega EverDrive, and also with Mega EverDrive Pro and MegaSD."

And what it says on the Doomworld page: https://www.doomworld.com/forum/topic/119202-doom-32x-resurrection/ "Selecting between no music, VGM FM music, or playing music from attached Sega CD (requires Sega CD in addition to 32X)."

It makes me think the game runs off the 32x cart and uses the Sega CD attachment to play the new music.

This is a 32X romhack, correct. If you run it from a flash cart (like the Everdrive) and also have a Sega CD attached, then that enables the other features.