To quote a sibling comment, who looked into the horses' mouth:
> Apple’s method of detecting known CSAM is designed with user privacy in mind. Instead of scanning images in the cloud, the system performs on-device matching using a database of known CSAM image hashes provided by NCMEC and other child-safety organizations. Apple further transforms this database into an unreadable set of hashes, which is securely stored on users’ devices.
https://www.apple.com/child-safety/pdf/CSAM_Detection_Techni...
In addition, they payload is protected at another layer by your user key. Only with enough mash matches can Apple put together the user decryption key and open the very innards of your image's payload containing the full hash and visual derivative.