Solve yields a generic result, while Reduce provides complete description of the solution space. With the MaxExtraConditions -> All option in Solve one can get in various cases as much as Reduce can provide however this isn't always possible.
The fact that Solve provides a generic result sometimes apears to be convenient as is the case here, however that generic solution need not always to be an actual solution.
More extensive discussion one can find in What is the difference between Reduce and Solve?
For an insight what kind of solution one might expect here we can sketch them with
ContourPlot[ (Sqrt[1 - y^2] Sin[x] - Sin[4 x]) x^2 + 2 x y == 0,
{x, -10, 10}, {y, -2, 2},
ContourStyle -> Thick, AspectRatio -> Automatic, ImageSize -> 600,
PlotPoints -> 90, MaxRecursion -> 3]

It is obvious thet there are solutions with -1 <= y <= 1 only. We can see that for certain real ranges of x thare is no solution, for others on can find one or two solutions. As we mentioned above Reduce is more powerful, nonetheless we can find solutions with Solve as well:
Solve[ (Sqrt[1 - y^2] Sin[x] - Sin[4x]) x^2 + 2 x y == 0 && -5 < x < 5, y, Reals]

Let's demonstrate that the "generic sollution" need not be an actual solution.
sol = Solve[ (Sqrt[1 - y^2] Sin[x] - Sin[4 x]) x^2 + 2 x y == 0, y];
ex1 = (((Sqrt[1 - y^2] Sin[x] - Sin[4 x]) x^2 + 2 x y)/. sol[[1]] // Simplify);
Plot[ ex1, {x, -5, 5}, PlotStyle -> Thick, WorkingPrecision -> 30]

y is a solution only when ex1 vanishes. Since it is hard demonstraiting with symbolic functionality we can reach satisfactory insight with plotting of the graph of ex1. One can easily observe that ex1 is not a solution e.g. for 3.5 < x < 4. Similar analysis for another "generic solution" ensures that we can get a specific solution only for appropriate ranges and simplifying the equation with a generic solution cannot yield zero in general. One can see how many different cases can be found with Reduce e.g.
Reduce[ (Sqrt[1 - y^2] Sin[x] - Sin[4 x]) x^2 + 2 x y == 0 && -10 < x < 10, y, Reals]
This output is very large and one realizes why there the system suppresses the output when no reasonable restriction for x is provided.
ContourPlotsimply generates lines in the plane{x, y}where this equation(Sqrt[1 - y^2] Sin[x] - Sin[4 x]) x^2 + 2 x y == 0is satisfied. It doesn't have anything to do with multiple roots. Nevertheless it appears to be helpful when analyzing possible solutions. There is an extensive discusion in the post I linked in the answer If you are not familiar with subtleties regarding symbolic equation solving functionality. – Artes Aug 23 '20 at 13:00