None of the sexually explicit material mentioned was in the retail version of the game.
Sorry but I have been in the software business for over 25 years and I have to call BS on your comment.
"None of the sexually explicit material mentioned was in the retail version of the game."
It sounds like the content was in the game distribution, but not accessable without hacking the game.
That's likely just enough of a distinction that it caused the ESRB to switch the game over to adult only.
I suspect the ESRB really didn't like getting all the bad attention due to the foolishness of Take-Two not removing that content completely.
How to open up such things always gets out, and the information on how to do it may very well have come from one of the developers.
Not giving it an Adult Only label kind of encourages companies who want to skirt the ratings from purposfully leaving in disabled content and then leaking a hack.
I wonder if they'll remove the content to get back their old rating, but also make an Adult Only version that doesn't disable that content?