Jets of material, a byproduct of the accretion disk and the black hole at the center:

https://www.youtube.com/shorts/xKVwPSZ-k1s

https://www.youtube.com/watch?v=9tcghbbglf4

A good analogy might be water swirling down a toilet. Or a hurricane, viewed from above. As gas swirls in, it heats up/"speeds" up so much that some of it tends to get flung out at the poles of the disk very quickly.

The actual physics of how that happens are unintuitive in like a hundred different ways, though, as the conditions are ridiculously extreme. It's very hot, the density of stuff varies wildly, there's a lot of radiation and electromagnetic interaction; it doesn't really resemble anything on Earth.