^ Yes they try to scam women and the elderly to make an extra buck. You could always try and sound knowledgeable beforehand by saying any one of a handful of things about particular parts of the car. (ie. The cabin filter is probably dirty but that's not an inspection requirement right?)
As far as the inspection itself, they check for turn signals and such too... general safety stuff. Yes anything can break during the year but the point is there's a deadline for you to get it fixed. Read here on everything they look for:
What Happens During A New York State Vehicle Inspection?
Have you seen the old Pimp My Ride shows based in California where before they fixed it up, the car was falling apart with side mirrors and bumpers hanging on by a thread? Do you want these types of cars flying down the LIE at 65mph in front of you?