I haven't had my morning coffee, so my ramblings may not make sense. But I'll have at it.
For internal (on-net) calls, once CME call control has identified and connected the calling and called endpoints, RTP and state information is exchanged between IP telephone endpoints. Voice traffic does not traverse CCME, as CCME just sets up the call and gets out of the way.
For external (off-net) calls, any IOS supported voice endpoint can be used to connect a call off a gateway. It may go H.323 or SIP to another gateway, to head to another site or the PSTN. The CME router would then maintain the call control as it is converted.
Hope this helps.
Pat