There are many things that the gaming sites have to consider when choosing/implementing an RNG. Without due dilligence, it can go spectacularly wrong.
To get a licence to operate a gaming site in a particular jurisdiction usually requires that the RNG has been certified by an independent third-party. The third-party testers will analyse the source code and run statistical tests (e.g. Diehard) to ensure that the RNG behaves randomly. Reputable poker sites will usually include details of the certification that their RNG has undergone (for example: PokerStars's RNG page).
I've been involved in a few gaming projects, and for one of them I had to design and implement the RNG part, so I had to investigate all of these issues. Most poker sites will use some hardware device for entropy, but they won't rely on just hardware. Usually it will be used in conjunction with a pseudo-RNG (PRNG). There are two main reasons for this. Firstly, the hardware is slow, it can only extract a certain number of bits of entropy in a given time period from whatever physical process it is monitoring. Secondly, hardware fails in unpredictable ways that software PRNGs do not.
Fortuna is the state of the art in terms of cryptographically strong PRNGs. It can be fed entropy from one or more external sources (e.g. a hardware RNG) and is resilient in the face of attempted exploits or RNG hardware failure. It's a decent choice for gaming sites, though some might argue it is overkill.
Pokerroom.com used to just use Java's SecureRandom (they probably still do, but I couldn't find details on their site). This is mostly good enough, but it does suffer from the degrees of freedom problem.
Most stock RNG implementations (e.g. Mersenne Twister) do not have sufficient degrees of freedom to be able to generate every possible shuffle of a 52-card deck from a given initial state (this is something I tried to explain in a previous blog post).
EDIT: I've answered mostly in relation to online poker rooms and casinos, but the same considerations apply to physical video poker and video slots machines in real world casinos.