All I know is I went from a Sound Blaster 16 Pro to an AWE 64 gold, the MIDI quality blew my mind. I believe this is the result of using instrument samples to render the audio instead of pure synthesis.

I also remember that the SB and other audio cards added MIDI lines into the DA-15 joystick port that for some reason resided on sound cards. This let people hook up real synths to render the music and I knew of one musician who did this with a keyboard though I never got to hear it live.