If the image is static, then just paste it to the canvas and resize as required.
If the image may be externally modified, the way shown above is convenient.
If you want to edit the image in paint or any other editor, then you might use the image region as for external files, while keeping the placeholder empty. Then you can set the file format in the context menu and launch an editor.
In my Introduction to SMath Studio I recommend this for quick sketches.
https://doi.org/10.25933/opus4-3370The benefit is that it is embedded in the worksheet (no external file needed) but still editable.
Also note that it is convienient to annotate sketches using formula regions on top of the image.
Technische Mechanik mit SMath Studio: https://link.springer.com/book/10.1007/978-3-658-50592-9