They deny this, but I have no idea how accurate the denial is.
https://github.com/dhowe/AdNauseam/wiki/FAQ#does-adnauseams-...
They should make it so that it talks to a VM (with no persistent storage) and sends the links to be opened to it (with the current browser's context such as cookies, etc so attribution still works).
It is the equivalent of installing an app that silently opens every attachment that is emailed to you.