Not sure if people are being intentionally dense but the violence depicted the trailer was far beyond the realms of realism that you'll see in 99% of all other game comparisons. Its also a very particular kind of violence which which gets under the skin more than just a quick gunshot to the head etc.
Arguably the most important thing is the audience which ND games appeal to. Although the games are violent, its been part of a wider, expertly crafted story telling experience. The audience for this game is not necessarily the same audience for other M-rated games which rely gore for cheap entertainment. The violence was used as a marketing gimmick whereas that wasn't the case in the past.
If this was experience in context of a 14hour game, it MAYBE wouldn't feel so gratuitous. But again, its a matter of taste and again many TLOU fans do not enjoy extreme violence for the sake of violence.







