About to start my first pistol. I have a 10.5 aero barrel and a shockwave blade with whatever buffer it comes with. I need a low profile gas block. Do I need to get an adjustable one? Not sure how the adjustable work.
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My Aero 10.5 has run flawlessly with a regular/standard low pro gas block, with my sample of one I'd say no you do not need an adjustable.

Generally the adjustables aren't necessary, but when you get into non-standard gas lengths and such it's nice to be able to crank the gas down if it's necessary.  If you shoot ammo of varying power levels this is a smart, yet not terribly expensive, bit of insurance for covering all the bases.

As for how it works it's a volume knob.  Need more gas, turn it up, less, turn it down.  It's that simple of a device.