The only one I've experienced (Massachusetts) wouldn't catch any of what we're discussing in this thread. They put it on the emission testing machine, walked once around the car, maybe checked the brakes, and that was it. It was in no way comparable to the UK's MOT test, which is a proper inspection.

Headlight function (including aim) is on the MA vehicle inspection: https://www.mavehiclecheck.com/motorists-basicinfo

Whether it’s done carefully or not, I doubt, though I did fail one year for headlight lenses too cloudy, requiring a fix and reinspection.