Bethesda's creativity has in general been very disappointing but we saw the signs already in Fallout 3 when despite the change of location far from the Core Region all familiar elements such as the Brotherhood, Super Mutants, the Enclave, Ghouls, Deathclaws, and such returned.
And their own additions have not been that much better, turning Ghouls into the Running Dead, characters and locations that feel out of place as they barely connect to the world or come over as something feasible such as characters roleplaying superheroes, a tower settlement with no means to really sustain itself, and much more.
I think Bethesda probably read some of the complaints about Fallout 4 and decided to 'throw a bone' by trying to make places feel grounded in reality, but they still wanted to perpetuate their out of place ideas like yet another source of Super Mutants, raiders and characters acting like they are out of a 20s/30s mobster movie, an advanced organization that for no reason is replacing people with synthetic replicas, an army that has access to a battle zeppelin and flying vehicles despite not having the advanced industry needed to build these, having previously depend on what they could salvage.
Both games are basically distilled Fallout tropes. Now a trope is not a bad thing but you have to use it properly as otherwise it is just a cheap gimmick and a nod of "this was in previous Fallouts".
And I don't think Bethesda is going to learn to do better in the future as it is marketing people deciding mostly what should be in a Fallout game.
