There are a lot of ventriloquists who would like to use puppets as a part of their act but this is not a requirement. If people would like to throw their voice out of nowhere, they can do this. There are some who may even use inanimate objects. It would depend on the concept that the ventriloquist is following and how the audience would react.
Using a puppet usually makes the audience happier because they are more engaged. They feel that they are actually watching an actual interaction even when it is just the ventriloquist that is controlling the whole conversation that is taking place. A good ventriloquist will be able to show his talent no matter what.