ProxySQL can be used with Amazon Aurora or other AWS solutions to improve security and performance. It can filter and redirect queries, caching results and load balancing connections across backend servers. Using ProxySQL's query rules, administrators can limit actions on the database by blocking or rewriting queries based on attributes of the client, query, or destination host group. This provides finer-grained control over queries than native AWS options alone. While ProxySQL has some performance overhead, using techniques like digest rules instead of regex matching can reduce this cost significantly.