The Create SQL feature will script out all the SQL statements to create the entire database for the currently selected database type. You can switch database types and create a schema for a different database type. You may design something for SQLite, output a script, then click Select Type and then choose SQL Server and create a script for that database. You can also open up a database in SQL Server, click Select Type, select MySQL and create a SQL Script based on the schema that was opened for SQL Server.
The Upgrade SQL feature will create the SQL needed to upgrade the schema of an existing database that was opened.