Cellular modems have existed for decades and come in many shapes and kinds. They contain the cellular baseband processor, RF frontend, protocol stack software and anything else required to communicate with a cellular network. Basically a phone without display or input.

During the last decade or so, the vast majority of cellular modems come as LGA modules, i.e. a small PCB with all components on the top side (and a shielding can), which has contact pads on the bottom so you can solder it onto your mainboard. You can obtain them from vendors such as Sierra Wireless, u-blox, Quectel, ZTE, Huawei, Telit, Gemalto, and many others.

In most cases, the vendors now also solder those modules to small adapter boards to offer the same product in mPCIe form-factor. Other modems are directly manufactured in mPCIe or NGFF aka m.2 form-factor.

As long as those modems were still 2G / 2.5G / 2.75G, the main interconnection with the host (often some embedded system) was a serial UART. The Audio input/output for voice calls was made available as analog signals, ready to connect a microphone and spekaer, as that's what the cellular chipsets were designed for in the smartphones. In the Openmoko phones we also interfaced the audio of the cellular modem in analog, exactly for that reason.

From 3G onwards, the primary interface towards the host is now USB, with the modem running as a USB device. If your laptop contains a cellular modem, you will see it show up in the lsusb output.

From that point onwards, it would have made a lot of sense to simply expose the audio also via USB. Simply offer a multi-function USB device that has both whatever virutal serial ports for AT commands and network device for IP, and add a USB Audio device to it. It would simply show up as a "USB sound card" to the host, with all standard drivers working as expected. Sadly, nobody seems to have implemented this, at least not in a supported production version of their product

Instead, what some modem vendors have implemented as an ugly hack is the transport of 8kHz 16bit PCM samples over one of the UARTs. See for example the Quectel UC-20 or the Simcom SIM7100 which implement such a method.

All the others ignore any acess to the audio stream from software to a large part. One wonders why that is. From a software and systems architecture perspective it would be super easy. Instead, what most vendors do, is to expose a digital PCM interface. This is suboptimal in many ways:

there is no mPCIe standard on which pins PCM should be exposed

no standard product (like laptop, router, ...) with mPCIe slot will have anything connected to those PCM pins

Furthermore, each manufacturer / modem seems to support a different subset of dialect of the PCM interface in terms of

voltage (almost all of them are 1.8V, while mPCIe signals normally are 3.3V logic level)

master/slave (almost all of them insist on being a clock master)

sample format (alaw/ulaw/linear)

clock/bit rate (mostly 2.048 MHz, but can be as low as 128kHz)

frame sync (mostly short frame sync that ends before the first bit of the sample)

endianness (mostly MSB first)

clock phase (mostly change signals at rising edge; sample at falling edge)

It's a real nightmare, when it could be so simple. If they implemented USB-Audio, you could plug a cellular modem into any board with a mPCIe slot and it would simply work. As they don't, you need a specially designed mainboard that implements exactly the specific dialect/version of PCM of the given modem.

By the way, the most "amazing" vendor seems to be u-blox. Their Modems support PCM audio, but only the solder-type version. They simply didn't route those signals to the mPCIe slot, making audio impossible to use when using a connectorized modem. How inconvenient.