Transfer on Death mechanics

Honestly, the designation TOD on an Account is sort of 'off-putting' to me. That acronym on my After Tax Investment Account is unsettling, to use the phrase.

All my accounts at Fidelity have my DW listed as Primary Beneficiary. She also has accounts at Fido and in the event of my untimely demise, she has instructions to 'assume' the IRA's.

What exactly is the difference between the TOD and Spousal Beneficiary ??
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