As an extension of accepted answer Oracle internally uses ROW_NUMBER/RANK functions. OFFSET FETCH syntax is a syntax sugar.
It could be observed by using DBMS_UTILITY.EXPAND_SQL_TEXT procedure:
Preparing sample:
CREATE TABLE rownum_order_test (
  val  NUMBER
);
INSERT ALL
  INTO rownum_order_test
SELECT level
FROM   dual
CONNECT BY level <= 10;
COMMIT;
Query:
SELECT val
FROM   rownum_order_test
ORDER BY val DESC
FETCH FIRST 5 ROWS ONLY;
is regular:
SELECT "A1"."VAL" "VAL" 
FROM  (SELECT "A2"."VAL" "VAL","A2"."VAL" "rowlimit_$_0",
               ROW_NUMBER() OVER ( ORDER BY "A2"."VAL" DESC ) "rowlimit_$$_rownumber" 
      FROM "ROWNUM_ORDER_TEST" "A2") "A1" 
WHERE "A1"."rowlimit_$$_rownumber"<=5 ORDER BY "A1"."rowlimit_$_0" DESC;
db<>fiddle demo
Fetching expanded SQL text:
declare
  x VARCHAR2(1000);
begin
 dbms_utility.expand_sql_text(
        input_sql_text => '
          SELECT val
          FROM   rownum_order_test
          ORDER BY val DESC
          FETCH FIRST 5 ROWS ONLY',
        output_sql_text => x);
  dbms_output.put_line(x);
end;
/
WITH TIES is expanded as RANK:
declare
  x VARCHAR2(1000);
begin
 dbms_utility.expand_sql_text(
        input_sql_text => '
          SELECT val
          FROM   rownum_order_test
          ORDER BY val DESC
          FETCH FIRST 5 ROWS WITH TIES',
        output_sql_text => x);
  dbms_output.put_line(x);
end;
/
SELECT "A1"."VAL" "VAL" 
FROM  (SELECT "A2"."VAL" "VAL","A2"."VAL" "rowlimit_$_0",
              RANK() OVER ( ORDER BY "A2"."VAL" DESC ) "rowlimit_$$_rank" 
       FROM "ROWNUM_ORDER_TEST" "A2") "A1" 
WHERE "A1"."rowlimit_$$_rank"<=5 ORDER BY "A1"."rowlimit_$_0" DESC
and offset:
declare
  x VARCHAR2(1000);
begin
 dbms_utility.expand_sql_text(
        input_sql_text => '
          SELECT val
FROM   rownum_order_test
ORDER BY val
OFFSET 4 ROWS FETCH NEXT 4 ROWS ONLY',
        output_sql_text => x);
  dbms_output.put_line(x);
end;
/
SELECT "A1"."VAL" "VAL" 
FROM  (SELECT "A2"."VAL" "VAL","A2"."VAL" "rowlimit_$_0",
             ROW_NUMBER() OVER ( ORDER BY "A2"."VAL") "rowlimit_$$_rownumber" 
       FROM "ROWNUM_ORDER_TEST" "A2") "A1" 
       WHERE "A1"."rowlimit_$$_rownumber"<=CASE  WHEN (4>=0) THEN FLOOR(TO_NUMBER(4)) 
             ELSE 0 END +4 AND "A1"."rowlimit_$$_rownumber">4 
ORDER BY "A1"."rowlimit_$_0"