this construction is often used in contrast to "because", so here is an illustration.

X is Z because Y --> this must actually mean that there is a literal cause-and-effect relationship. in other words, this sentence claims that "Y" is actually the reason why "X" is "Z".

X is Z in that Y --> this is a qualifier; it implies that "Y" is the only certain way in which X is Z.

two examples:

My brother and I are alike in that we both have a quirky sense of humor
--> CORRECT
this sentence means that my brother and i share the same quirky sense of humor, but that we may (or may not) differ in any other aspect of our personalities.

My brother and I are alike because we both have a quirky sense of humor
--> UNREASONABLE MEANING
this sentence implies that our similar senses of humor have CAUSED our personalities to become alike. that's nonsense.

"in that" is a subordinating conjunction that connects two independent clauses (i.e., two complete sentences). so, the structure of any sentence correctly using "in that" is:
(complete sentence) IN THAT (complete sentence)

the part that comes before "in that" is obviously a complete sentence, so let's just look at the part that comes after it.
i'll adopt the color scheme used by the above poster:

D的意思是她使用嗓子的方式就像其他音乐家使用instrument的方式一样，in that（我在这里的理解是通过，that就是嗓子）来自由的变换节奏
E的话approach的动词是接近 开始 意思是她开始用像其他音乐家的乐器的嗓子来唱歌，ranging在这是有歧义的1.可以用作approach的修饰，变换着节奏来开始 2.和using 并列，通过自由控制节奏来唱歌，其实都是not make sense的

D中的in that不是很理解诶，求大神解释

求问that 前面可以加in吗？

E 如果by using, ranging, flattening并列，那么最后一个动词前，应该以and/or收尾，但E选项没有，错误。
多项平行的最后一项应该以and/or收尾

句子开头是Deliberately imitating the technique，所以划线部分的主语一定要是人，而不能是Billie Holiday’s approach，排除AB。
C like后面是句子，错误。
E 如果by using, ranging, flattening并列，那么最后一个动词前，应该以and/or收尾，但E选项没有，错误。