Atmospheric dread candy. Not quite the Edgelord driven mindless horror you're thinking (not this one at least) but it finds a pulse on a reverse-slasher cold-blooded thrills. Ingeniously harsh on difficulty to a slight degree of realism, tailors you to engage on stealth takedowns than face-to-face combats since you won't go far against crowds of goons, with a highly janky and inconvenient combat for you to absolutely praise thy heavens at the sight of firearms.
Gunplay is clunky but ensures a challenging hardship given how receiving gunfire drops your health significantly, facing off mobs of goons to increasingly more powerful firing squads face an equal amount of difficulty as you'd drop dead as easily as your enemies. Bombastic action doesn't mesh too well with this antiquated cover shooter shtick but it grooves to grindhouse horror messiness by the fantastically bonkers finale where you navel-gaze towards squads of tactical forces.
The takedown system is a neat way to face the player's fascination towards violence- It's not truly necessary to perform them as vicious as they're sold, and yet, these avoid monotony to the player's gameplay (at least until you realize there's just one animation for each gravity of execution). I kept finding amusement at the simplicity of a plastic bag.
It's an imperfect and janky action-adventure of sorts but i truly admire the asphyxiating tension and nihilistic premise as a framework for a morbidly Noir quasi-survivor horror exploitation film playing you as the hero. Carcer City stands as some of the most inhospitable worldbuildings ever imaginable by Rockstar Games right next to hospital spawnpoints on GTA.