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Abstract: ALMA observations now routinely provide sensitive, cloud-scale (<50 pc), multi-tracer diag- nostics of molecular gas and star formation in nearby galaxies. This wealth of information plus the ability to cover large populations of extragalactic star forming clouds is sharpening our understand- ing of how star formation is regulated in galaxies. I will review key results in this area from the first five years of ALMA observations as well as several new projects that are currently underway. I will also describe new techniques for synthesizing the wealth of information provided by ALMA on cloud-scale gas and star formation towards to goal of testing models for how galactic environment contributes to regulating star formation in galaxies.