Jonathan, Worms make you do pretty evil things and we love it!
Also there would be a 'disconnect' or lacking motivation for a gameplaying girl to rescue a girl, perhaps balanced out by chance to beat up on men.
There's a serious disconnect between what I want to do and what genres let you do.
These days (or even in the mid 90s), a platformer could basically be infinitely cliché-free, but as long as you did the 'same old' it would still be boring.
Seems the innovation has to be in the player's possibilities, what he does in the game. Then if it has to be a genre (f.ex. due to platform limitations) that's not too bad, as long as it doesn't get in the way. And it can even involve forest and sewer tiles then.
What you do then defines the player's role in the game, and the "specifics" like graphical style, presentation, genre, "hard things to solve to progress" follow from that.
Elite - you travel in a huge universe, you trade and shoot ships. Roles: trader, navigator, fighter pilot, either in good or evil mode. Huge change in thinking.
Tetris - you rotate and fit puzzle pieces, but it's an action game against the clock.
Lemmings - your "soldiers" move automatically and you're their "general", giving them roles to beat the map. They can walk, block, build, dig, explode...
Worms - Basically your soldiers can do what Lemmings can do, but also use a huge selection of weapons, and you control them individually. The map is also an enemy to be used to your advantage or hinder your progress.
Exile - JetPac with a single huge interesting world, it's up to you to discover its secrets. You're a marooned spaceman. You can fly, walk, use many weapons, turn mushroom spores into bombs, use misc robots, tools and alien creatures to accomplish tasks.
Paradroid - you're a mind control device sent to take over 'a' spaceship full of robots. You can solve a puzzle to take over a robot, and then you can move in 8 directions and shoot. Prime example of the simplest of control methods, yet what you do is enough fun to make you play it. No idea why it works, but it is immersive and there's this feeling of exploring a big hostile world.
I'm 100% sure you could make a fun genre game with cliché graphics with AMOS, SEUCK, or any other tool, as long as
1) The role of the player is specific and interesting
2) You do different things that are fun/interesting to do.
3) The method of doing those things (jumping, kicking and punching, shooting, pushing blocks, flying a heli, eating stuff, whatever) can be super simplistic, but the controls should give a nice feedback. Ie. the core gameplay can be "moving a sprite in 8 directions with the joystick" and nothing else, the important thing is that the control that lets you "do cool stuff" doesn't get in the way/is annoying.
If 3) is addictive in itself and sound/gfx/presentation is immersive, that's a huge plus ofc. But immersion is harder to achieve on limited platforms compared to what we're used to now, with detailed 3D, infinite sound channels and infinite memory.
Scoring systems, lives, hi-score tables, 1ups, bosses etc came from early arcade games and were invented to make the player insert another quarter. Games were simple, so a hiscore was a simple means to add a layer to the basic game idea. Why play? To learn how to get the most score to appear in the hiscore hall of fame, to survive as long as possible to make the quarter last, to beat that boss. Converselty, bosses were added to challenge the player so he wouldn't be able to play forever on a quarter. etc.
There's not really any need for those gimmicks in a purchased game that someone plays for fun at home in his spare time. Elite was the first game to properly challenge this mindset.