Is this most efficient?
Hard to tell without profiling. There's always a bottleneck somewhere. For example if you are cpu limited, and the algorithm can't be made more efficient, that's probably a hard limit. If you're storage bandwidth limited, and you're already using efficient read/write caching (typically handled by the OS or by low level drivers), that's probably a hard limit.
Are all cores of the machine actually used?
(Assuming python is running on a single physical machine, and you mean individual cores of one cpu) Yes, python's mp.Process creates a new OS level process with a single thread which is then assigned to execute for a given amount of time on a physical core by the OS's scheduler. Scheduling algorithms are typically quite good, so if you have an equal number of busy threads as logical cores, the OS will keep all the cores busy.
Would threads be better?
Not likely. Python is not thread safe, so it must only allow a single thread per process run at a time. There are specific exceptions to this when a function is written in c or c++, and calls the python macro: Py_BEGIN_ALLOW_THREADS though this is not extremely common. If most of your time is spent in such functions, threads will actually be allowed to run concurrently, and will have less overhead compared to processes. Threads also share memory, making passing results back after completion easier (threads can simply modify some global state rather than passing results via a queue or similar).
multithreading on each CPU?
Again, I think what you probably have is a single CPU with 128 cores.. The OS scheduler decides which threads should run on each core at any given time. Unless the threads are releasing the GIL, only one thread from each process can run at a time. For example running 128 processes each with 8 threads would result in 1024 threads, but still only 128 of them could ever run at a time, so the extra threads would only add overhead.
what to read up on?
When you want to make code fast, you need to be profiling. Profiling for parallel processing is more challenging, and profiling for a remote / virtualized computer can sometimes be challenging as well. It is not always obvious what is making a particular piece of code slow, and the only way to be sure is to test it. Also look into the tools you're using. I'm specifically thinking about the database you're using, because most database software has had a great deal of work put into optimization, but you must use it in the correct way to get the most speed out of it. Batched requests come to mind rather than accessing a single row at a time.