I believe it does take a few smoke breaks, unless you live in California and got the non-smoker version.
On a more serious note, by default, all AV/Malware scanners should be working in the background 100% of the time if their "Real Time" mode is active. That is what it means after all, it runs in real time, always scanning when there is an action that triggers it whether it is initiated by the end user or some other software event. What triggers a scan could vary from product to product but for the most part, when there is a file read/write/compression/decompression type event, it should scan the files/folders involved.
Since it is event based and only focuses on involved files, it doesn't do a thorough scan of every file or directory. That is its weakness. A deep manual or scheduled scan is more effective in that sense but running a deep scan when Windows is up and running, a pesky malware can hide/morph from the scans so ideally, running in the deep scan in Safe Mode would be much effective.
That said, if your scanner has a "Boot-Time" scan feature, that would be much much better (even free AVG/Avast has that feature and that is really the only scan mode I use with those).
Still, a really pesky malware (Trojan/Rootkit) can very easily dodge such a scan as well, especially if it created a hidden partition which Windows and any software that runs from within Windows couldn't see/access.
That is why running a scan from a bootable media (mainly based on Linux) would be way more powerful.
Of course, ultimately, when I realize it is a Class A malware, I typically opt to do a fresh install after backing up needed data if applicable.
Important:
Only one AV app should be running on any machine which is why if you install a 3rd-party AV/Malware scanner that runs in Real-Time mode, Windows Defender will automatically deactivate its own Real-Time scanner.
I have seen machines where multiple such 3rd-party apps were install, and they are not inclined to let the other guy run the show.
Multiple apps running in Real-Time spells trouble. They could very effectively fight with each other and render each others scan ineffective/incomplete.
I have actually seen cases of infected machine where the user had Norton, Avast and MalwareBytes installed thinking this would make their machine more secure.
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