SoundNote[] uses standard MIDI. By default, the pitches are Equal temperament, A = 440 hz. The MIDI standard allows you to alter the pitch, but I have found no (easy) way to do this.
MIDI should be an obsolete standard, mostly because it defaults to Western, equal tempered scales, which is really appropriate for Western (Eutorpean) music since 1760 or so. (Bach's Well-Tempered Clavier was written to exhibit the utility of a well-tempered scale, not equal temperament.) Indian, Chinese, and older Western Music (e.g. Baroque and Renaissance and before) use different scales.
Looking at the new audio functionality is on my list of things to do. I haven't checked this out, but you might be able to create an audio entity using SoundNote[], specifying the instrument, and then manipulate the pitch using AudioPitchShift[]. If that works, then you could wrote a function that would wrap up the code and have as an input one of the various MIDI instruments.