If a lead comes in from a source other than SalesForce, Marketo will automatically search for a pre-existing record using email address as the unique identifier. If it finds one, no new lead will be created. Information may be altered on that pre-existing lead if you dont
block field updates from various sources.
If no match on email address is found, a new Marketo lead will be created. If you want that lead in SalesForce, you have to set up smart campaigns to push it there.