Well, you could have an "off-line" or a DC-DC converter... both are considered SMPS. In an off-line switcher, the AC is rectified & filtered (then a PFC stage in most) and then fed to a DC-DC converter. The "switch mode" part is that the DC voltage is "chopped up" (switched on and off) producing a square wave whose duty cycle can be varied and filtered to produce an other DC voltage. A switch mode power supply is generally more efficient than a linear supply. For example using a linear regulator to reduce 12VDC to 5VDC @ 1A the regulator would dissipate (12-5)*1 watts, in this case 7 watts. That's an efficiency of ~41% where as with a SMPS, say a buck converter, you could make the same voltage reduction at an efficiency in the 90's. That's a big reduction in wasted power (heat).
It's "not really" the output transistor that's switched on/off and there is always an LC of some type after the "switching device".