The inspiration for the character's creation extends Salvato's concept of an innocuous romance game that slowly falls apart over time as horrible things begin to happen and one girl takes control.

[3] Salvato stated that he began to see more "reality" in Monika's design when writing her, wanting to explore her as more than just a generic anime character.

In creating the game's horror elements, Salvato drew inspiration from Yume Nikki and Eversion, emphasizing to his team that he wanted the market for visual novels to become much more daring and less reliant on the same plot concepts.

[6] The game's other stock characters, namely Sayori, Yuri, and Natsuki, were based around standard anime archetypes (such as childhood sweetheart, girl next door, tsundere and manic pixie dream girl) and were given Japanese names to emphasize a pseudo-Japanese atmosphere characteristic of Western-produced visual novel, with each character's dialogue being written as though poorly-translated from Japanese.

The sole exception to these formats is Monika, who received an English name and speech pattern as a hint to her individual nature compared to the other characters.

[10] Salvato recognized that a product of such quality would not satisfy potential players,[10] so he made a request to his friend, a translator for Sekai Project, for sketches of school uniforms and hairstyles for the character.

After Kagefumi's departure from the project, Salvato contacted the freelance artist Satchely, who created the final character sprites over the course of the following few months.

This drastically changes her attitude towards the other girls upon realizing she was not available to be picked as a romance option by the protagonist, having been written to be a two-dimensional supporting character.

She discovers that, as the president of the club, she is able to manipulate the script and code of the game and break the fourth wall, leading her to manipulate the script to do things like emphasizing the negative traits of the other characters Sayori and Yuri (respectively depression and self-harm), in the hope that the player would choose her instead of them, only for the player to turn to the "worthless" Natsuki for platonic companionship.

[14][15] In 2018, Monika was added to Yandere Simulator as a playable character,[16][17] taking the role of an obsessively lovesick schoolgirl nicknamed "Yandere-chan" who seeks to "eliminate" (kill) anyone she believes is attracting her "senpai's" attention.

Later discussion is given on the creation of a second "control" universe within VM1, in which "A" is not made aware of their elevated permissions, paralleling the events and settings of the side stories, with the researchers planning to transform the contents of VM1 into a visual novel format in order to ensure the security of the project, leading into the events of the original Doki Doki Literature Club.

[24] This level of popularity was surprising to creator Dan Salvato, to where he questioned whether her sociopathic behavior is justified, or whether she was redeemed in the end.

[29] PCGamesN writer Mitch Jay Lineham considered Monika's story tragic, discussing how she is just a side character in a video game, and how the player and the real world represent a place she can be more than that.

[2] IGN Japan writer Shohei Fujita talked about how the moment where Monika and the player are left alone as being frightening, worried that things like glitches or startling elements might occur.

[30] Destructoid writer Charlotte Cutts regarded Monika as a "detestable character," stating that from the beginning of the game, something felt off about her.