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I think people do use it that way, but historically it specifically refers to Carteret County, maybe sometimes Ocracoke or Hatteras, but specifically east Carteret, places like Atlantic, Cedar Island, Harker's Island, etc.
I've seen people/organizations from Wilmington to Rocky Mount use it more recently. I guess it makes good marketing.
I lived in Carteret County for several years and I've been visiting on a regular basis for decades. I've always understood "Down East" to be east of Beaufort. The lifelong locals refer to everyone not originally from the area as "ding batters."
I think it's indisputable Raleigh is Piedmont with it's gently rolling hills and occasional pebbles in the soil. But if we were to only divide NC into East and West, I suppose culturally Raleigh has more Eastern characteristics than Western.
Culturally, there are definitely more Eastern NC characteristics. I think there's a stronger relationship with areas further east than west. Take a random person in Raleigh, and chances are that person is more familiar with Goldsboro or Rocky Mount than Reidsville or Lexington. People west of Durham don't know Eastern NC at all. I ran into someone from a Winston-Salem suburb who had never heard of Wilson. On the contrary, I ran into someone from Hertford County who made day trips to Raleigh a few times a year to visit Crabtree Mall.
Growing up in Eastern NC, Raleigh was always considered "the City" to us. Pretty much once you entered Wake County coming from Wilson or Johnston, you were no longer in Eastern NC.
I have heard Wake and Johnston Counties called Eastern NC since I arrived in 2009. Coming from SC, I never really understood why, as it seems much more central to me but that is what I have heard it referred to. I suppose if you draw a line halfway between the farthest western point and the farthest eastern point, it may fall on the eastern side.
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