The Airplane Multi-Engine Land (AMEL) rating is a class rating added to an existing pilot certificate. There is no separate FAA multi-engine knowledge (written) test — all theory is examined orally and demonstrated in flight.
If your multi-engine training and checkride are conducted in a centerline-thrust airplane (engines on the longitudinal axis, e.g., Cessna 337 Skymaster), your certificate will carry the limitation "Limited to center thrust" (14 CFR 61.5/61.31). To remove it, you must pass a practical test in a conventional (wing-mounted-engine) twin.
Standard 14 CFR 61.57 recency rules apply (three takeoffs and landings in 90 days for passenger carriage; tailwheel landings to a full stop). There is no special multi-engine currency rule, but insurance and operator minimums are typically far stricter than the regulation.
Holding an instrument rating in the airplane category extends to the multi-engine class automatically once you hold AMEL — you do not earn a separate "multi-engine instrument" rating. However, recent IFR experience under 61.57(c) is logged by category and class as appropriate.