For standard, well-defined integrations, say, syncing NetSuite with Salesforce or a common e-commerce platform, middleware tools like Celigo or Boomi offer prebuilt connectors that handle a lot of the object mapping without custom code.
For anything outside that standard mapping, a custom field, a business-specific workflow, a system that isn't on any connector's supported list, the real work happens through NetSuite's own API. SuiteTalk, REST or SOAP, handles getting data in and out; SuiteScript and RESTlets handle logic that needs to run inside NetSuite itself, triggered by a record changing or a schedule.
The manual fallback, when neither of those is set up, is someone exporting a CSV from NetSuite and importing it elsewhere by hand, or re-entering the same data into a second system. That's usually where we get the call.