The game's nudity and sexual content were originally supposed to be completely uncensored at release, but to avoid receiving the Adults Only rating from the Electronic Software Ratings Board, certain sex scenes had to be cut, and genitalia had to be censored to ensure a Mature rating in North America. The PAL versions contain the original unedited experience, which would eventually release in North America under the title "Leisure Suit Larry: Magna Cum Laude (Uncut and Uncensored!)"

On the Crappy Streets, the bar that Larry Lovage's uncle Larry Laffer hangs out in throughout the game is named "Lefty's Too". This serves as a reference to the original Lefty's Bar, the starting point of Leisure Suit Larry in the Land of the Lounge Lizards.

On Koko's loading screen, she is depicted as having a pronounced bulge in her underwear and a flat chest, foreshadowing her reveal as Spoiler:a transgender woman or a cross-dresser (her identity is never specified aside from having a penis). Koko's genitals are never actually seen in-game and are only implied through jokes about wieners and hot dogs. This includes a scene in the game's ending where Larry Laffer is seen dancing with Koko, and for one subliminal frame, clip art of a hot dog appears over her crotch.

In January 2014, a now-deleted review was posted to the game's GOG page from an account named "Thraxamer", claiming to be an unidentified lead designer on the game. From context clues across the internet, it's believed that the identity of the account is co-lead designer Duncan McPherson. The account name Thraxamer appears on two different websites attached to a Duncan McPherson, once in a thread on the forums for the game engine Construct, and again as an email address on a member page for The Federal Vampire and Zombie Agency, a science fiction enthusiast website created by writer Richard S. Dargan. The member profile for Duncan McPherson on the latter site lists a specialty in "game design", and shows him as being based in Monmouth, Illinois, where High Voltage Software's Duncan McPherson graduated from Monmouth College.

According to McPherson, High Voltage Software had little say in the development of Leisure Suit Larry: Magna Cum Laude other than the story, which he had to fight to ensure the writers had creative control over. Executives at Vivendi Universal, who purchased Sierra Entertainment and obtained the Leisure Suit Larry IP, believed that point-and-click adventure games were no longer marketable and that the series had lost its appeal. They demanded that High Voltage Software make the series "relevant to the 19-22 year old set" and gave them a treatment that focused on sexual content in a similar vein to films such as "American Pie" and "National Lampoon's Animal House" (previous entries in the series avoided full frontal nudity, instead favoring innuendo). The game's teaser trailer also pokes fun at the series' previous protagonist Larry Laffer, where he appears as a cardboard cutout greeted to empty applause and cricket chirps in an attempt to paint him as outdated compared to his nephew, Larry Lovage. Despite this, McPherson stated that he was "still very proud of that team and what they did, in the face of a difficult set of requests."

This is the first Leisure Suit Larry game that had no involvement with series creator Al Lowe. According to Lowe, he had been in talks with Sierra Entertainment to work with them on the game, but eventually stopped receiving contact from them as the company downsized. In a post on his personal website, Lowe slammed the game and its developers for what he viewed as a disgrace to the series:


Lowe also published an email sent to him from uncredited writer Cary Okmin, who revealed that the game had been fully written well before Lowe began discussions with Sierra Entertainment. Lowe later stated that playing Manga Cum Laude felt like "receiving a video from my son's kidnappers.":

The models who appear at the loading screens portraying the real-life versions of the in-game girls were uncredited. It's unknown who most of the models were that portrayed the real-life counterparts, however these are the following that are currently confirmed:


A real-life counterpart of the girl Zena Zepplins was also planned to be included for the loading screens, portrayed by model Ally Lane, however it never was included in the game.