Everything worth knowing, nothing that isn't.
What it does
It accepts messages over REST or SMPP, routes each to the right operator via the appropriate interconnect, handles encoding and sender IDs, and returns delivery receipts and inbound messages. See /answers/what-is-sms-api and /answers/what-is-smsc.
Gateway vs aggregator vs CPaaS
The terms overlap: a gateway is the technical connection layer; an aggregator resells operator connectivity wholesale; a CPaaS adds developer APIs and more channels on top. Most modern providers are all three. See /answers/what-is-cpaas.
What makes one good
Direct operator routes, real-time operator-level delivery receipts, high throughput over SMPP, sender-ID and compliance support, and an uptime SLA with failover. See /answers/how-to-choose-sms-provider and /answers/what-is-route-failover.