An icon-only button needs an explicit aria-label like "New post" — a bare "+" icon means nothing to a screen reader. It stays in the same spot regardless of scrolling, so it's usually position: fixed (or absolute relative to the viewport).
A variant that fans out several related actions on press is called a "speed dial," and its trigger additionally needs aria-haspopup and aria-expanded, handled like a menu button.
The difference from an ordinary button is hierarchy — it's not one of several buttons on the screen but usually the only one, representing that screen's "default action." Placing two or more FABs on one screen breaks that hierarchy.