Color me unsurprised, but Hatred has come back from the ESRB with a very rare “Adults Only” (AO) rating, something the industry rarely ever sees in favor of the far more common “M for Mature,” that most violent titles receive, including the likes of Grand Theft Auto. It’s similar to the also-rare NC-17 rating among movies that’s a step above R, and both classifications pose distribution problems for the media in question. NC-17 films have a hard time finding theatrical distribution much of the time, and few retail outlets will carry AO games.
Source: Technology