The scene was built in Blender, but the entire foreground boat was made with Gravity Sketch. This also shows a different position for the chain, before the client asked for it to be moved higher.
Eevee render in Blender to compose a shot and test lighting.
Line drawing on top of geometry
In this easter-egg version, the point of interest was swapped out for a ramen stall
These backgrounds are designed for a upcoming mobile game. The general theme for these backgrounds is gameplay inside the human body, in particular the cardiovascular system. The usual workflow for creating these images involves setting up a line sketch, often with a quick 3D blockout beforehand, painting the flats for each layer, and lighting it.