I like Berserk and I liken my interest in its gratuitous violent imagery and dark themes as the literary horror-enthusiasts equivalent to adrenaline seeking behavior. Adrenaline junkies do not want to be in real danger because they can get hurt, but they want the sensation of it. They seek the sensation of it in a safe way. Similarly, I as a Berserk reader don't want to be a butcher. I have a passing interest in the macabre, but I don't want to work in a museum of horrors.
In case you don't know, Berserk is a long running manga (comic) that has been adapted into an anime multiple times. It's a dark fantasy about a man who kills demons with a massive sword. It is firmly in the seinen genre. Seinen means "young men", not boys. Its target audience is adults with male interests. It has mature themes; it has some nudity and lots of violence. It's horror. Some of the horror is very mundane; for example, the evil deeds of regular men include torture and various cruelties. Some of the horror is more cosmic. For example, the setting has a generic western religion like Christianity, but the religion is false within the setting. The god in Berserk is indifferent to human suffering, and there is no heaven. Further, God is responsible for the presence and empowerment of man-eating demons who's physical might far exceeds ordinary men. This is dark stuff.
One of my favorite parts is when they introduce Farnese. She's a young noble woman who was assigned to this symbolic position as a leader in an army that answers directly to the setting's equivalent of the Vatican. The story slowly reveals that she's a pyromaniac because they used to burn witches alive outside her bedroom window when she was a little girl and so now, she has a cruelty-streak because of it. As an adult, she thinks she understands God's divine order for the world - then she meets the hero who's perpetually stalked by things that should be an abomination to that divine order. This is tantamount to forbidden knowledge, and encountering demons causes her to go temporarily mad and lose her faith. I consider loss of faith a form of cosmic horror in a way that loss of a hand is body horror. It's interesting. There also may or may not also be a scene where she grinds her groin on the hero's sword which is neither here nor there. Don't worry about it.
The point is there's a lot of complex and inappropriate stuff in this series. Before you judge me, let me explain. Given all this wild stuff, it's done artistically. That is to say, there's artistry in the choices made for when and where and how to depict this stuff. It doesn't show nudity for its own sake. It's not used to please the audience. It doesn't show gore for the sake of it. It shows these things with an intent of evoking a sensation in the audience. Some scenes are intended to be disturbing or sickening. If doesn't show blood and gore insipidly, it's precise. There's a scene for instance where the hero stabs a very attractive, naked villainess thought the stomach and she derives sexual pleasure from this. It mixes the sensations of horror and sexual thrill. The result is a weird sickening sensation that you feel in your gut. This is why I liken the horror of Berserk to adrenaline seeking behavior. Berserk does the sensation of horror like skydiving does the sensation of adrenaline.
Like I said, the series does this with precision. It picks its moments. It does not indulge. If every panel had something horrifying, you would become desensitized and it would lose its effectiveness. There are quiet contemplative moments where characters sit around a fire and talk about their dreams. Real life years and years of content later, some of those characters get eaten alive and it's shocking. So, in summary, I read Berserk for this artistic use of this subject matter, not the (over) indulgence of it.
Now, would I put this subject matter explicitly in my TTRPGs like Dungeons & Dragons? The answer is a firm no. Why? Because I know that it's not for everyone. Also, even I would probably be uncomfortable. That said, I refuse to overly sterilize or over sanitize my setting as I believe this is infantilization and kitsch. I would be happy to say that some of these darker things exist in my setting, because their absence would be conspicuous. By conspicuously absent, I mean it would be distracting and immersion breaking if something wasn't present. In other words, how can you believe there is danger in the world if the world is too nice and safe? Therefore, some of it exists implicitly in the setting. Let me use a very safe metaphor to illustrate my point. Puppies die. When I say puppies die, this is code (or a euphemism) for any horrible thing you might imagine. Implicit means yes, there are puppies that die in the setting, but we don't need to show puppies die. Sometimes, it's good enough to hint that puppies die off-screen. We don't need to indulge in puppies dying, but they do.
Even Star Wars, a franchise considered to be intended for children, has torture, sexy dancers, war, slavery, murder, dismemberment, brother-on-sister kisses, use of deadly poisons, no bras in space, and off-screen youngling slaying. In conclusion, we're not doing gore-fest, but you do need to pick moments in fiction to absolutely splatter someone.