Am I the only one who recognizes that context plays a role here?
It's my understanding, and I could be wrong, that the ESRB doesn't actually play games to review them. The developer/publisher seeking a rating submits a video representing 'typical' game play across the spectrum that a player can be expected to experience. This is why GTA: San Andreas got it's original M rating because of course Rockstar wouldn't have submitted footage of the content unearthed with the Hot Coffee mod, because that content is simply not accessible without modding the game (and breaching the EULA if I'm not mistaken). I still think that the ESRB re-labeling GTA:SA as an AO game after the fact over a user created mod was bullshit, so take it for what you will.
So in context, a game where you play a street thug going on crazy adventures that involves gunfights with cops (who are armed antagonists trying to stop you) and the possibility of civilian casualties? Now compare that against a game whose sole purpose appears to be recreating a hate filled psychotic killing spree where the slaughtering of innocent civilians is the goal. In games like GTA it is a possibility, but I never remember a story mission that tasked me with slaughtering civilians on purpose for the sake of killing civilians. Saints Row is just balls to the walls crazy, and comes off as so over the top and cartoony; it's almost satire it's tongue is so firmly planed in it's cheek. Compare either of those two to HATRED? Especially with the wave of mass shootings that have struck the United States in recent years? That might be enough to push a borderline game over the edge into AO territory. Especially if the footage they were supplied is far more graphic and visceral than what we have access to. But that's another thing to remember, as of yet all we have is screenshots and trailers, none of us have seen the footage the ESRB was given to evaluate; none of us have played the finished game. There simply could be more than we are not aware of. Or the ESRB could arguably be overacting, both are possibilities.
Now I'm all for freedom of expression, to let the developer make the game they want. If you don't like it, vote with your wallet and don't buy it; simple as that. Will an AO rating stop me from purchasing it? No. Will I buy it just because it has an AO rating? Nope. It will depend on whether or not it's a good game. You can make a compelling game experience out of almost anything, but without playing the game itself I cannot make that call for myself. That being said, I'm not terribly impressed with what I've seen so far.