The most important changes are to your metabolism.
Sure the heart gets stronger, you might produce more red blood cells, etc. but your muscles will adapt to produce energy for longer duration which is different from the way they adapt to weight training (getting larger and having more peak/short term energy).
Your muscle cells will make more mitochondria (power house of the cell), which will allow them to burn more fuel and make more energy. They will suck sugar in from the blood, reducing insulin resistance and diabetes risk (as well as risk for heart disease, dementia and cancer). This is so dramatic it can even cancel out bad diet. Look at any serious runner and they likely consume several times the amount of simple sugars as a normal sedentary person but they have none of the consequences of it because the sugar is burned in their muscle rather than being converted to fat.
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