Comment by ketzo

If it's coming from someone who could even remotely be considered a "host" to you, it's definitely a serious question, and they actively want to fulfill any needs you might have. Southern hospitality is a super real thing, it's pretty awesome.

If it's said as a greeting, "how y'all doing?" usually means "how are your family?," which also tends to be meant very genuinely.

Even outside of a host-guest dynamic, I do think Southerners tend to care more about pleasantries; when they ask about your weekend, they're a little more likely to really want to know.

Of course, this is all very broad strokes based on anecdotal experience. Plenty of cold/self-aggrandizing jerks in the South, too!