A lot of registration spam comes from emails with a subdomain. Spammers control a domain such as buymyjunk.com and then attempt to register on your site with emails such as irenemwd@foster2.buymyjunk.com and jakemgm@foster7.buymyjunk.com. This plugin simply blocks all registrations using a subdomain.
Reputable users will have a normal email address from a reasonable domain like @gmail.com, @mylegitbusiness.com, @outlook.com, @myschool.edu, etc.
There is no configuration and no setup. It simply just works. The plugin logs all blocked registrations so you can find potential false-positives. Find a link to this log file on the Plugins page where you activate/deactivate this plugin.