There are three main actions that the player can decide to play:
Play a valid combination of cards on the table.
Add one or more cards to an existing combination of cards.
Draw a card from the deck if you don't play any cards.
The defining feature of Machiavelli is being able to make changes to the combinations of cards already on the table. The current player, if desired, may reorganize the cards in order to make new combos that make it easier to play one or more cards in his hand. All new combinations must be valid, and players can not remove any cards already on the table.
The player who manages to play all the cards in his hand wins the game.
There is a fundamental difference from Rummy/Manipulation: there is no discarding, which makes it far more difficult to get rid of all cards.