I understood your doubt.
In fact, in linear programming, there is no comparison or assignment. There are restrictions. The solver is the one who assigns values.
When you say "the sum of the routes that go from city i to city j is equal to 1", you are including a restriction in your solution.
When it says model += decision_var[i][j] == 0, that is also a restriction. Here it can be said that, in the end, you are assigning a zero value to decision_var[i][j], as your restriction includes only one variable. But this is a restriction.
In the case of the sum of routes, the solver will assign a value of 1 to any of the variables involved in the sum to guarantee the restriction.
So, you can include ==.
Suggestion, include the line model.write('my_sol.lp') at the end of your code. This will generate a file with your complete solution. You can analyze and check whether your constraints were generated correctly.
Att,
Luciano Almeida