They require a proctor such as a librarian or someone in academia and you have to show ID. For the ones I've taken, they are sent the exams, you show up to take them, then they return the exams. If you are remote to the college and have connections who are dishonest, it would be possible to cheat. I took Math 140 distance ed and you had a lot of assignments to do and return. You could potentially cheat on those a little easier since you do the work and return it in an envelope (might be online today). But I'd guess they would compare exams with homework to make sure it looked like the same author. It would be fairly hard to cheat on the exams from my experience.