This only applies to region in the GUI context (JASS Rect). I do not think it is possible to determine units inside a JASS Region efficiently.
The process for getting a random unit in a JASS Region is considerably slower and more complex.
1. Rough enumeration of units in region. This can be as simple as all units on the map but the best fit would be all units in either the smallest bounding circle or Rect that fully contains the Region.
2. Filter rough enumeration to produce group of units in Region. Test each unit if it is inside the Region, discard if not. Best done using destructive loops due to the destructive nature of this filter process.
3. Apply random victim algorithm on Group of units in Region to produce Group of random units. GUI has one, although it may or may not leak.
Since most Region objects are constructed from a simple Rect, try and stick with Rect enumeration for maximum speed.