In Rails, to add or remove columns from a database table, you first generate a migration file. This file is like a recipe for changes but does not affect the database until you run it. You then edit the migration file to specify adding or removing a column, including the column name and type. Running the migration applies these changes to the database schema. After that, your Rails model reflects the updated schema, allowing you to use the new or removed columns in your code. Remember, generating a migration file alone does not change the database; running the migration is necessary. Also, when removing columns, specifying the column type helps Rails safely identify the column to remove.