Explanation
mkusb-dus can create boot drives from iso files and [compressed] image files
file.iso
file.img
file.img.gz
file.img.xz
by cloning (and there is a special case to extract windows.iso files). The shellscript dus-live is used for that purpose.
Persistent live drives can be created by dus-persistent from iso files.
"But the very detailed explantions I find for how to create a persistent OS on the USB all have links to download mostly img files"
I would explain it like this: Any system can be cloned to an image file (which in turn can be compressed). Those are links to image files of persistent live systems, which can be cloned by dus-live.
The reason to create such images is that if the computer running an installed Ubuntu system in UEFI mode, it will not be possible to install and use the package grub-pc to make the target persistent live drive bootable in BIOS mode (because there is a conflict with grub-efi). But in a persistent live Ubuntu, both grub-pc and grub-efi can be installed alongside each other.
So it is possible to create systems that boot also in BIOS mode from a persistent live system running in UEFI mode. And if you have a fast internet connection, it is convenient to download a compressed image file and clone it.
The manual
man dus
may add details to this explanation.
Edit 1: bugfix to make mkusb explain and help solve this issue
Thinking twice about your question, I realize that this is confusing. So I have started to improve the code in the menu part, the shellscript dus. Thanks for asking this question. It helps me improve mkusb :-)
Since you are a coder, I want to explain what I am doing. It is not uploaded yet, but I am modifying the function p_persistent which prepares for the call to the shellscript dus-persistent. The version number will be updated to 12.1.3.
There is output, a zenity window and red text to the console window. The variable src_orig is reset to zero length.

I am also adding code to skip to cloning (calling the function p_live) in the main section of dus (near the end of the shellscript file), if dus is called with a file name as parameter, and the file extension is not iso.
if [ "$source" == "" ]
then
p_starter
elif [ "${source/.iso}.iso" != "$source" ]
then
p_live
else
p_install
fi
Edit 2: mkusb 12.1.3 is uploaded
I hope that the new version, mkusb 12.1.3, will make things less confusing. It is uploaded to ppa:mkusb/unstable and to phillw.net. Please try it and report back :-)