The actual execution was a mess, but Skullface's inspiration for his parasite weapon being the experience of linguistic imperialism as a child was a really novel premise. The idea that he would get his revenge by creating a weapon that killed anyone who spoke English is some cool super-villain shit I don't think I've ever encountered before. "Race-selective" weapons, genetic-targetting weapons, religious indoctrination viruses, I've seen all those, but I think MGSV is the only time I've encountered a weapon that targets a language community.
I think he's really good at evoking feeling through visual storytelling, and finding gameplay that mostly kinda reinforces those themes.
The underlying themes in his work often don't hold up to fridge logic, but it's still an engaging and memorable experience while you're playing. Death Stranding was one of my favorite games I played last year (hashtag patientgamer...).