The built in 'diffuser' in a typical flash unit is NOT a true diffuser, it merely spreads the amount of area of the subject which is illuminated...for example, rather than being limited to the FOV of a 24mm it is spread to cover the FOV of a 16mm lens or 20mm lens.
Real 'diffusion' means that the light source is noticably larger in surface area than the original unaltered source of light. A typical flash lens might be 1.5" x 2.5", and even with the wide angle 'diffuser' it is still a mere 1.5" x 2.5"...no larger at all. If you flip up the 'catchlight' panel found on Canon flash units, it still is only about the same area as the flash lens...it merely reflects some light to the portrait subject's eyes while the flash head is pointed upward at 60 or 90 degrees (where the ceiling itself becomes the 'light source' and serves as a true 'diffuser' of light).
For macro work, if you use something to make the apparent size of the 'light emitter' bigger than the original 1.5" x 2.5", you begin to make it a 'diffuser'...a 5" x 7" softbox on the front of the flash is dimensionally small, but relative to the size of your subject when it is only 10" away, that 5" softbox is really big! Using a 16" x 20" softbox would be a HUGE light source.