Medium format, meaning 6x45cm, 6x6,6x7,6x8,and 6x9, looks 'different" from 35mm. In digital, many of 2019's "medium format" cameras use 44x33mm sensors ( cameras from Fuji, Hassy ,and Pentax), and deliver clean, crisp detailed shots, with ~50MP to 102 MP resolution. Today's 45-50 MP 24x36mm or "full frame cameras" deliver nearly as much detail. It's a matter of both MP count and really good lenses.
In film, I think 645 looks better than 35mm by way of a somewhat larger negative area, less grain, and lower DOF in most situations. 6x6 makes amazing 5x5" proofs..sort of in-between 4x proofs and enlargements.
One difference: 35mm has hundreds of zooms available (used and newer) while MF has VERY FEW zooms available, so framing is different. In 35mm we tend to "shoot tight", in MF --not quite so much, both due to format aspect, and lens choices. 6x6. being SQUARE, removes the need to flip the camera, ever, and so composition/framing is often a post-shoot decision.
The issue with 35mm has long been the 3:2 aspect ratio, versus the 6x4.5, or the 6 x 6 or the 6x7 aspect ratio, so the "takes look" different.. 3:2 is very "tall" when shot in the vertical.
Also....... for people uses, the waist or chest-level POV of a 6x6 camera using a WL viewfinder is subtly different than the higher, eye-level POV of a 35mm camera. Tripod-mounting, framing, then reacting to a person with direct eye-to-eye contact is VERY different than seeing the person through the camera, and it is a different "experience", more like "directing actors" when using a large, tripod-mounted camera and interacting eye-to-eye with people.
There is more to it than just "equivalence" in focal lengths and apertures; medium format photos can easily look very different than small-format photos, especially when people are involved. Not better technically necessarily, but "different", mostly in artistic and aesthetic ways.
Shooting with a 6x6 film SLR and a 150mm f/4 is different from shooting 35mm 3:2 with a 70-200 zoom.