Conceptually they are similar; one has config files in /etc/resolver/*, other in /etc/systemd/resolved.conf.d/*.conf; one has mDNSResponder process (yes, it is also unicast DNS resolver and cache, since 10.6, despite the name) and the other systemd-resolved. With systemd-resolved, you can achieve exactly the same thing as with MacOS resolver, for approximately the same cost.

With systemd-resolved, you don't have to adjust resolvers manually as links come up and down, NetworkManager's VPN connections play nice with it, while DNS resolver handling in Mac VPN software (including Wireguard and Tunnelblick) is a nuasance :(.