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Global hacks - things that change the way the game acts just in general, not something you work with on a specific lot, will be activated automatically if custom content is turned on in your game. Object hacks or menu-related hacks - ones that you have to change options on an object, or spawn an object by clicking on the sim/ground will require that you do that, then click on the new object to get whatever options. There are also ones where you click on a sim to direct them to do things (like the Hula Dance & More pose hack, which lets you pose and animate your sim by clicking on them).
You'll need to read the description of what you download to see how to use it. It may require a little bit of digging through the creator's text to see where they say that. If you're in doubt, ask them - individual creators support their own work.
my simblr (sometimes nsfw)
“Dude, suckin’ at something is the first step to being sorta good at something.”
Panquecas, panquecas e mais panquecas.