I guess, every note get's retuned. For example, here is tx81z programmer's tuning window for octave:
Full keyboard tuning editor is the same, but continious from c-2 to g8, so you can retune every key.
Madronalabs Aalto can load scala files, but you can't edit tunings. When i play note sequence from c3 to b6 pitch changes continiously according to scale you select, it can be chinese 60 or javanese pelog (7 notes). So midi notes are just a set of triggers and with Aalto you can ignore 12 TET notation system, especially if you have Madronalabs Soundplane:
or haken continuum.
But system wise midi notes are still с-4s and a#3s etc