Comment by SigmundA

SQL server has image, text, varbinary(max) and varchar(max) none of those except varbinary(max) are filestream enabled, and varbinary is only file stream if that is setup and the column is specified file stream when created otherwise its in the DB like the others.

image and text with READTEXT and WRITETEXT are deprecated but still work fine, varbinary(max) and substring UPDATE.WRITE are the modern equivalent and use the same implementations underneath.

Filestream allows larger than 2 gigs, stores the blob data in the filesystem but otherwise is accessed like the other blobs along with some special capability like getting a SMB file pointer from the client for direct access. It is also backed up and replicated like normal, definitely not just like storing a path in the DB.

Filestream performs worse the in db for blobs under about 100kb I believe where it would be recommended to keep them in db for max perf.

I have used MSSQL blobs long before filestream existed and it works well except for the 2 gig limit and once the db gets large backup and log management get more unwieldy than if you just stored them outside the db but it does keep them transactional consistent, which filestream also does.