My understanding is that difference is in scope, not performance.
Hosts files will only affect the host (workstation/desktop/laptop etc) they're installed on.
Things like piHole try to make it easy to apply the solution to all members of your network - which even in household cases these days can number in dozens, making it impractical to manage hosts files for all of them (This includes items like phones which are typically unfeasible to mess with hosts file).
Pie hole also has a nice browser interface to debug blocked requests that are breaking the site you don’t want To be broken. Which happens inevitably when you pull together 10 different sources of blocked lists.... or just one persons whose ideal blacklist doesn’t match yours.
Hosts files will only affect the host (workstation/desktop/laptop etc) they're installed on.
Things like piHole try to make it easy to apply the solution to all members of your network - which even in household cases these days can number in dozens, making it impractical to manage hosts files for all of them (This includes items like phones which are typically unfeasible to mess with hosts file).