Some schools will try and put in minor effort to match people with known similar interests, backgrounds, etc., but for the most part it's random based on who is available and other logistical considerations.
My school asks applicants for their top 3 most interested fields and tries to match up interviewers with interest, but it's also dependent on who is available that day. Not everyone will get matched accordingly, but an effort is made.
It varies hugely by school. Plenty are random; I know my school (Downstate) tries reeeeally hard to match you based on interests/experiences/something. (Mine actually had an almost creepy number of things in common with me - including something I hadn't included on my application!)
Based on feedback I get from premeds applying to multiple institutions and my own experience, I'd say that 10-25% are (seemingly) paired with interviewers having a similar interest or research focus.
I had 2 interviewers where the faculty worked in either the area I did research in or the area I majored in for undergrad. Talked to other students at those interview days and they said they were similarly paired up, so some schools must make a decent effort.
They did this at my undergrad and it was awkward because they counted poor people as minorities, and then everyone at minority events who wasn't the expected sort of minority stood out/surprised the hosts/the hosts told them they must be in the wrong place.
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