After you create an account, you will be directed to setup your account. From this section, you can:

• Set preferences, such as timezone, notifications, and colors.
• Connect with advertising API's
• Add additional users
• Add domains
• Get tracking code

If you connect with the API's, we suggest that you sync accounts so you can immediately manage adgroups and keywords / placements. You will have the option to choose which accounts (if MCC) and campaigns to control. This is great for marketers that want to take a test drive first. 

For non-API connected  campaigns, such as Facebook, Advertise.com, email campaigns, etc. You should create new campaigns under the campaigns tab. You can then get the tracking URLs for adgroups. Update your ads to reflect this URL and you're all set.

After your tracking code is in place, you will see data updated in real time. Once data can be measured, things will get interesting and useful.

API