Resolution
CCM.exe does not have to be running on a Music on Hold (MoH) server. Stand-alone deployments of an MoH server require a Cisco CallManager installation. However, CCM.exe should be disabled.
With co-resident deployments of an MoH server, CCM.exe is typically enabled. You have more capacity from a stand-alone deployment since this server is dedicated to running only MoH. All MoH servers are part of the cluster, and they must participate in the Structured Query Language (SQL) replication scheme whether they run CCM.exe or not.
You remain bound by the current limit for the number of servers running CCM.exe in the cluster.