Why do the Ghouls in Fallout have no noses? I ventured into the digital wasteland to try and find out

As the show (and the ghoulification perk) make clear, not all ghouls are withered.

It is a progression: newly ghoulified humans look normal but survive deadly radiation and non-immediately fatal injuries. Over time they shrivel and slowly lose sentience, getting more and more impulsively violent until they go full feral. Also, not all "tender parts" shrivel: at least one has a use for ghoulettes. 😁

Depending on the extent of exposure, some go straight to feral or even glowing. At least one glowing ghoul retained a semblance of sanity (whether sane or not is debatable) and could speak.

The show hasn't included supermutants or synths, yet, but both also exist in a spectrum from peaceful and friendly to homicidally hostile.
 
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