I think some ultraviolence in video games is okay when it's presented as a bad thing. Hotline Miami comes to mind where it forces the player to look at what they've done and reflect on it. It turns the adrenaline pumping action sequences into horror as you realize you and your character are not right in the head. You're forced to quietly reflect as you exit the building past dead and mutilated bodies.
One of the problems I've had with modern games is how much they normalize the military. It's no secret the DoD and CIA have their hands in video games. They can use unrealistic violence as a recruiting method. Players get used to the idea of blowing up Arabs with goofy ragdoll physics, completely isolating them from the violence inflicted in the real world.
Saving Private Ryan caused military recruitment to drop and it never recovered, even after 9/11. The powers that be realized they dropped the ball but were saved by pivoting to video games. A game with Come and See, Saving Private Ryan, or Schindler's List levels of realistic violence could potentially turn people off to war as a game. This has never been done as far as I'm aware.