They ensure you don't get a garbled filesystem.
They also expose an API that allows you, if you're very careful and really know what you're doing (like danluu or the SQLite author), to write performant code that won't garble files on random shutdowns. But most programmers at most times would rather just let the OS make smart decisions about performance at the risk of garbling the file, or if they really need Durability, just use a library that provides a higher level API that takes care of it, like LMDB or an RDBMS like SQLite.
To not get your file garbled, you need to use an API that knows about legal vs. illegal states of the file. So either the API gets a complete memory image of the file content at a legal point in time and rewrites it, or it has to know more about the file format than "it's a stream of bytes you can read or write with random access".
Popular APIs to write files are either cursor based (usually with buffering at the programming language standard library level, I think, which takes control of Durability away from the programmer) or memory mapped (which realllly takes control of Durability from the programmer).
SQLite uses the cursor API and is very careful about buffer flushing, enabling it to promise Durability. Also, to not need to rewrite the whole file for each change, it does it's own Journaling inside the file* - like most RDBMSs do.
* Well, it has a mode where it uses a more advanced technique instead to achieve the same guarantees with better performance