What actually happens to your file
The tool opens the PDF, imports every page into a new document, and writes that document out with its content streams compressed. Where the original stored page content uncompressed — which is common in PDFs produced by older software, by export scripts, or by tools that prioritise speed — this removes a lot of bytes.
It is worth being clear about what it does not do: images inside the PDF are not downsampled or re-encoded. If your file is large because it contains high-resolution photographs or page scans, most of its weight is in those images and this tool will barely move it. Reducing the images at the source — before the PDF is created — is the effective route.