Yes. The sample can submit metadata in the form of bounding boxes to the XProtect VMS. If the metadata source is then added to a camera as related the Smart Client will display the bounding boxes on top of the camera footage. See this explanation - https://doc.developer.milestonesys.com/html/index.html?base=samples/boundingboxmetadataprovider.html&tree=tree_2.html
Is a client plugin the only way to get a metadata overlay that is not a box or text? For example, a bitmap overlay?
Yes. You are correct. When you implement a client plugin you can use any shape as overlay.
Analytics Overlay plugin sample is the simplest sample to show this.