When you use the default save button the main object and all associated objects are saved. If you create a save microflow you will have to save all objects explicitly. But that is half the story.
In case of 1:1 assocations AND images (or filedocuments) the uploaded image is always created and stored immediately after upload, not just after pressing save. Because the image has a 1:1 with the main object this is also saved. In case you would press Cancel the main object is canceled but not the image.
To the best of my knowledge, the default 'save' button will indeed save the referenced object(s) as well.
If this is not the desired behavior, you can create your own 'save' button using a microflow that will commit only the main object and close the page.