Two passes at the same terrain
Because the 100 mile is the same out-and-back run twice, you know exactly what is coming the second time through, which some runners find mentally easier than an unfamiliar point-to-point course. But it cuts both ways: the steepest section, at the Greek Peak ski slopes, hits you again on tired legs late in the race, and there is no fresh terrain to distract from how you are feeling.
The elevation gain for the full 100 is genuinely disputed between sources, somewhere around 20,000 feet on one accounting and upwards of 22,000 feet on another. Either way, that is a serious amount of vert for an out-and-back format, and you should plan for the higher end rather than get caught underestimating it.