In addition to the Literature Club, MC is given a proper personality, Monika is changed from her original hidden yandere personality and there are some new characters:

The personalities of the Literature Club girls have been greatly expanded beyond the stereotypes presented in the original game and have complex relationships with each other that change depending on who MC falls in love with and the choices he makes. It is technically an eroge with two H scenes but these can be deactivated.

The choices MC makes have a significant impact on the mental health and personal life of his chosen partner for better or worse. The main character (simply called 'MC' by the mod developers) seeks to woo the club member of his choice while they struggle with their personal issues. It is inspired by Katawa Shoujo's sincere portrayal of disabilities with a variant of Emi appearing as a supporting character. ''Doki Doki Blue Skies'' is a mod which overhauls the Visual Novel Doki Doki Literature Club! into a more conventional experience without the meta horror but maintains a strong focus on mental health.