Hi Linda,
Some machines have built in designs ready to use for stippling or quilting. You can add quilting around an applique to make a quilted block.
The other option is using an Embroidery design from a vendor. You download or send to the machine from lap top.
I have just started with some machine quilting ITH projects. This one was done with EMB squares alternating with 15 plain fabric squares. The quilt squares were sewn together, the quilt sandwiched, and hooped. I chose the design size according to the size of the fabric square.
Each square was positioned (centered) in the hoop (ITH) and the design stitched through all the layers. Typically designs are layered with batting and the design stitched right into the square. All the quilt squares are sewn together and then a backing is added using a SITD method. This can leave the backing a little floppy and I didn't want that.
I've done mostly traditional stabilized projects in the last four years and wanted to try a new technique. With this technique no stabilizer is used. I used a magnetic hoop for this method. My machine has a camera so I was able to scan the hooped quilt into the machine and adjust the placement of the design as needed. I can say you need to be comfortable with hooping and design placement to successfully quilt ITH.
This is a just a sample of the quilt alternating the EMB blocks with the stippling blocks. You can see the EMB design in the plain square.
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Hope that helps! It is a fun hobby with lots of options and techniques to learn!