There aren't really much changes to the graphics or audio in this DLC. I'm pretty sure the National Guard would be called out if this happened. I understand it's a video game and there's very little realism, but it still felt very strange that no cops showed up at all. You are careening across freeways and streets, blasting at enemies with your turret gun, while getting shot at, cars are exploding, and there are zero cops. There's a mission that has you, Donovan, and your target escaping a New Bordeaux office in a Humvee while enemy Humvees are chasing you. It works really well in the jungle battles, but feels very out of place in New Bordeaux. You use the turret to destroy the various vehicles changing you before they can blow up your vehicle. Donovan drives the Humvee and you mount the 50 caliber machine gun on the back. It helps a lot if you're trying the stealthy approach, which I recommend given just how many mercenaries you have to face. You highlight a small circle and any enemy in that circle is sniped.
It's basically like throwing a grenade, but instead of an explosion there's silenced sniper shots.
Another CIA buddy of Donovan's, Marshall, helps during the mission and offers sniper support during combat.
There are two new main features to the gameplay in Stones Unturned: turret combat and sniper support.