They need to be ready to actually rewrite large portions of it if they do.

Often these end up with strange character dynamics that made more sense looking at the source material. If you cut the smut out without adding new content it just becomes weirdly empty.

I think it depends. Cause some stories do it tastefully and others skip over it without noting anything which makes the story feel like something is missing

Depends on the material, but most things can be adapted just fine to a lower rating. Like, I don't think the Fate franchise would have blown up as much as it did if it retained its explicitly pornographic game aspects in its adaptations

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