Aligned is a choice in the option bar for the Healing Brush tool, the Clone Stamp tool, and the Pattern Stamp tool.
Below, the use of Aligned is illustrated with the Healing Brush tool.
The use of Aligned is similar when you're using the other two tools.
When Aligned is not selected, the sampling point remains at the initial sampling point.
This single sampling point is used again-and-again, each time you click to clone.
Here's half of a clown.
The right side of the clown photograph has been removed to make it easier to see what's happening.
Aligned is not Selected.
The left eyeball was sampled.
You can see the circle with crosshairs on the eyeball.
When the Healing Brush tool is clicked to retouch, the paint is coming from the sampled eyeball, each and every time.
Below, the cursor was placed on the right side, and was clicked.
This was done two more times.
You can see how the area that was sampled initially, the eyeball, is used over-and-over.
Now, let's select Aligned.
When Aligned is selected, the sampling point moves in tandem with each movement of the brush.
The sampling point doesn't stay at the initial sampling point.
Again, the left eyeball was sampled, and Aligned is selected.
When I moved the brush, the crosshairs of the sampling point also shifted in tandem with the brush.
Below, when I clicked to retouch the blank area, the Healing Brush used the hair as the retouching paint.
Here are the crosshairs on the hair, not the eyeball, even though the initial sampling point was the eyeball.
When I move the brush, and clicked a second time, the sampling point shifted as well.
The retouching paint for the second click came from the lip area, not the eyeball, the point of the initial sample.
You can see the crosshairs on the lip.
So, Aligned is somewhat like having the entire photograph on your brush as a painting.