For Death Stranding 2, Kojima wanted Sam (played by Norman Reedus) to…

“With Norman, since we’re working with him, of course we’re going to handle with care how he looks, down to every baby hair.”

“Inside that room, it's not really Sam, it's basically Norman.”

For Death Stranding 2, Kojima had to turn down around half of the cameo requests from famous people: scanning each person in the studio took about fifteen minutes, and the team ran out of space on the project.

“would start from zero”

Kojima explained an optional encounter in Death Stranding in which Sam periodically delivers medicine to a man who has no direct importance to the main plot. If the player forgets to continue bringing the medicine, the man will die. With that mechanic Kojima wanted players to experience that forming a connection also means taking on responsibility, and that their actions can both build and break that connection.