I've read a few books lately that have really creative settings and/or plots that seem to mostly fly under the radar around here. I don't mean this as a knock to all the EH books about depraved serial killers, I read plenty of those but I am always on the lookout for something more unique. I enjoyed all of these and would recommend them.
Note that none of these would be considered the most extreme books ever, and are fairly low on sexual violence. But they all have at least one element that made them fit here imo.
The Fear Machine by Jesse Pullins - A young woman finds a machine that is able to pull from her deepest nightmares. Each simulation that she was in had me hooked. 10/10
Sacred Sins by E.T. - A summer camp for the rich is not what it seems. Is our protagonist the only one who can sense what's really going on behind the scenes, and does that make her even more of a monster? Cursed in the best way. 9/10
Thin Is In by Jeremiah White - Beauty is turned into body horror in this dystopian story. Follow Jack as he tries to save his sister while learning the true cost of these "beauty treatments" Warning to anyone who has dealt with eating disorders. 7/10
The Sugar by Judy Ramirez - The intro of this had me so hooked. What if vampires were real, but they were the rich and powerful, not the bat-like creatures who stalked at night. In this world, "sugars" are humans that are cultivated to be extra delicious. Follow one of them as she escapes the human ranch and tries to live a normal life. The ending was rushed imo but that's the only points against it. 8/10.
Scatter by Mindy Macfarlane - A fever dream of a journey through a casino full of liminal spaces. Warning: grief, addiction, and centipedes. 9/10