She is a tsundere given a backstory of domestic abuse by her fictional father, with her traits ultimately becoming more pronounced due to Monika's intervention in the game's files.

[1] Salvato created stock characters based on anime archetypes that were given Japanese names to emphasize a pseudo-Japanese atmosphere.

[3] Due to Salvato's lack of artistic skills at the time, he created the designs of Natsuki and other characters in a free anime-creation program, which were used in a test version of the game.

[4] Salvato recognized that a product of such quality would not satisfy potential players,[4] so her final design in-game was handled by freelance artist Satchely.

Natsuki returns in Yandere Simulator, added to the game as a playable character in 2018,[6][7] in which she takes the role of an obsessively lovesick schoolgirl nicknamed "Yandere-chan" who seeks to "eliminate" (kill) anyone she believes is attracting her "senpai's" attention.

"[12] Destructoid writer Charlotte Cutts identified seeing Natsuki throw up upon seeing Yuri's corpse as one of the most shocking things she has ever seen in a video game.

She also noted that her aggressive behavior to the protagonist, rather than being a product of Salvato's writing, was an in-universe rewriting caused by Monika's narcissism.

[15] Natsuki became the subject of a meme, where people would analyze her appearance and mannerisms in order to determine whether she was assigned male at birth, referred to as a "trap" (calling her "Trapsuki").

People argued this because she has broad shoulders and a flat chest, though others found that her proportions mirrored a cisgender woman's.

She stated that both cis and trans women have significant body variance, making such analysis unreliable to distinguish them.