Amongst Diablo runners it is common to edit adria's sound file. This adds no impact to the game other than potential comedic humor. Sound files are on average between 1-2 seconds in length, with the longer being cut off. Takes about ~5min to set up, can be done during Diablo setup.
Examples of Audio files:
"Abandon your foolish quest" (Diablo)
"Tuturu" (SteinsGate)
"Moo" (Cows)
"FrankerZ" (Meme)
The name will show up every time I add skill points to my character. On average I do this 3-5 times during the run. Names would be limited to a max of 15 characters
All Diablo players remember the butcher, and the horrors he forced them through.
The butcher has a 2/3 chance of spawning, if he spawns I will be forced to kill him. Simple kill, no real time loss other than the ~1min to find him.