Entertainment Software Rating Board

The Entertainment Software Rating Board (ESRB) is an organization that provides age ratings in video games. It was created in 1994, and it serves in the United States and Canada. Its primary goal is to inform parents and adults which video games are suitable for children.
Controversy.
The AO rating.
Some critics come to believe that the ESRB only rates games AO if they have sex in them, regardless of how explicit the language, violence or even blood is. This also lead them to think the ESRB is not doing its job. Twenty-three games have received and kept adult ratings, but apparently twenty (almost all) games were given it for sexual themes and content. Two had violence, and the other one was given the "Adult" rating for real gambling.
"Tone Down" controversy.
Some publishers of games decide to tone down the game's explicitness in order to qualify for an "M" rather than an "AO" rating. For example, the game had an original M rating, but the game that could be unlocked by bypassing the patch, called "Hot Coffee", seemed to spark major controversy with the game, because it features sex and erotica. Thus, the ESRB decided to re-rate the game as an AO. Rockstar Games then chose to leave the game out of the release, then release an exploit fix that completely disallowed access to the game. However, other games have trouble being "toned down". Thrill Kill, for instance, was given an AO, and then Electronic Arts decided to purchase the publisher, Virgin Entertainment. The release of the game was then canceled, and the game never was toned down.