Basically there are 2 types of 12v cooling out there, as other have mentioned. Actual compressor units like your home fridge that have a compressor motor and refrigerant. Then there are the thermo-electric units using Peltier-effect cooling with little more than a fan.
The compressor units will get much cooler and stay cooler, even in brutal heat, but they are more expensive. Overall they use less electricity. The Thermo-Electric units draw alot of electricity 24/7. They do not cycle on and off like the compressor units. They also are limited to generally being able to cool only about 40 degrees less than the ambient temperature. If you are in a 100 degree car than means cooling to about 60 degrees. Not cool enough for food safety.
The Thermo-electric coolers are good for short-term use, like transporting cold food from the grocery store on a long trip home, or keeping pre-chilled foods cooler on road-trips. I have several of them in various sizes.
I have modified a few of my thermo-electric coolers to have much more powerful fans on the hot side to vent off the heat produced. It makes the units cool about 10-20 degrees better. I also find that they work best with pre-chilled food/drinks in them. They are power hungry and need to be connected to a vehicle's 12v system to draw power when the engine is running. They will draw down a starting battery in a few hours if the engine is not running.
I would like to get a 12v compressor unit, but they are so expensive. Right now for off-grid, I use large auxiliary batteries, a pure sine-wave inverter and standard 120v AC dorm fridge(s)