Amazon Prime Now is basically direct courier delivery from the closest warehouse to your house. the app only presented things that were readily available in your area.
My understanding was that it was distinct inventory at a distinct warehouse optimized for same-day fulfillment. At least in SF years ago, they had cold items like eggs and ice cream (before the Whole Foods merger).
But whats weird is sometimes inventory would be different depending on if you were on the primenow website, or browsing amazon.com for same day or fresh. Sometimes prices were even different - like items would be on sale from primenow but full price on amazon.com.
I very much miss prime now restaurants though. It was the best, no extra fees or anything other than a tip.