I think the largest flaw of this map by far, is the inclusion of the E1M4 recreation as the level's "super-secret" of sorts. This area should absolutely have been a separate level and it's inclusion into the main level just serves to weaken both experiences, although I will give my thoughts on that section later.
The main part of the map is, frankly, a treat. Despite having nearly as many enemies as Mazu's Forbidden Brutal Religion, this level is actually fairly compact, managing to cram a whopping thousand enemies into a fairly small space. While that level felt like each combat section had twice as many enemies as it should, this one manages to avoid that pitfall by through smart encounter design. For the most part the large enemy count makes encounters frantic in a way that fits into Quake's flow. I say for the most part as several encounters do feature enemy spam, but even those are often paired with powerups to turn what otherwise would be a chore into a cathartic gibfest. It cannot be understated how much the liberal placement of powerups throughout the map made the overall experience that much more enjoyable for me. That, coupled with several interesting sections like the vore telefrag portal and the spawn hallway meant that this was the only giant superlevel I have experienced where I actually felt like replaying it after finishing it for the first time rather than take a rest. This too despite the level being absolutely brutal and giving the player very little breathing room. The sheer relentlessness with which the maps throws enemies at the player is both commendable and pairs extremely well with the visual theming. Speaking of which...
Visually this is one of the most unique maps I have played so far, it nails the hellish-industrial theme to near perfection. The combination of angular metal corridors, struts and vents with blood, sacrificed corpses and satanic imagery gives the map a uniquely unsettling atmosphere. There is a feeling of underlying wrongness that permeates the whole map, from the clashing of the hellish and the industrial, through the inexplicable runes and symbols, to the level itself sometimes seeming to scream as you are going through it; it makes it seem that this is less of a building and more so a living demonic space that actively wants to torment you. It speaks volumes that I, someone who usually does not like the more hellish and abstract levels still loved the atmosphere here, simply because of how well executed it is. It's literal enough to get it's ideas across and abstract enough to be actually scary. The only flaw it has in this department is the sci-fi Mars skybox clashing heavily with the hellish theme of the level proper.
Now the reason why I'm not actually giving it 5 stars and the maps largest flaws after the inclusion of the E1M4 section are the platforming and the 50 button hunt. This map has a LOT of platforming for secrets, consisting of a lot of very narrow platforms which require needlessly precise jumps (including one that literally had 1-unit thick platforms!). This is made all the worse by several of them being easily bypassable by rocket jumps. There was more than one point where I rocket jumped because the platforming was so bad that I genuinely thought I was doing it wrong and rocket jumping was the intended way to progress. I think the absolute worst at this is the window platforming near the fish secret, as the windows are so narrow that you can't jump in them and need pixel-perfect movement to get across. The E1M4 section has one that not only is a perfect rocket jump area, but also requires you to touch a damaging area in the platforming. I do get that being able to reach an area without taking damage should require it to be harder than a rocket jump and I do appreciate how this levels lets you reach every single area without taking damage (outside of two platforms in the E1M4 section) but these are so needlessly precise it flips back around to being pointless. Not only should the platforms have been much bigger, there should also have been a LOT less corner jumps. I also think that the intended way to reach some areas is sometimes convoluted. Buttons don't always hint at what they open and some secrets often lack an obvious indication as to how you are supposed to enter or exit them. The fish secret is opened by a button that does not look like one and you are likely to only find it by accidentally pressing it, which isn't ideal considering one of the 50 buttons is in it.
Which brings us to this map's elephant in the room. Unlocking the E1M4 section requires the player to press a whopping FIFTY buttons hidden throughout the map, some easy to find and some needlessly hard. While I am not opposed to this idea on a base level, I think the way it's done here just doesn't work. Fifty buttons is a lot and requiring a player to search such an intricate map for 50 buttons, several of which are pretty well hidden is a bit of a tall task. I think for this map the best solution would have been to have a room open near the exit elevator with a 3-dimensional display of the map and the rough location of each button. This would make a nice bonus for players who beat the level but are still missing buttons while giving them an idea of where to actually go instead of being stuck in a wild goose chase. Even with noclip, fullbright and buttons highlighted enabled I still had difficulties finding every button and I cannot imagine how hellish it would have been to find them normally. I actually don't think reducing the number of buttons would help as the reason why this puzzle is so annoying is less so the number of buttons and more the extremely intricate nature of the map. I will say however that putting the last button into the already hard to find fish secret was just torture.
pressing all 50 buttons unlocks FOUR more buttons in the exit elevator that when pressed finally transport the player to the E1M4 section. As I said earlier, this section is essentially a secret level and is not required to finish the main level, which makes it's inclusion as part of the map detrimental to the whole experience. The section itself is a sort of remix of E1M4, upscaled and with better visuals. Due to sticking to the overall layout of E1M4, this part lacks most of the magic that makes the main level work so well. Large open spaces and lack of cover to maneuver through turns a lot of this section into a peek and shoot slog. The spiral staircase descending into Shub-Niggurath, the overhangs with shooters and the final bridge to the exit look like exciting setpieces at first, but you quickly realize that the only way to beat them is by slowly advancing while taking the enemies out one by one from cover. Trying to play through it normally will just result in you getting hit by a million projectiles and quickly eviscerated. The visuals and setpieces are just as creative as before, but the actual gameplay takes a huge dip in quality here. I think it's best encapsulated by the floot button puzzle. The original E1M4 had 5 floor buttons that needed to be pressed, each one activating a nail shooter whenever the player was above it, with some enemies also in the room. This one has twice as many buttons, the shooters now shoot rockets and the room is populated by a large horde of zombies, several upside down vores in the ceiling and multiple spawns are thrown in as the previous enemies die. It comes off as a bad attempt at making a setpiece cooler by just adding more and more of it, to the point it almost becomes a parody of itself. It's a shame because it's a disappointing end to an otherwise great map.
I have rambled on enough at this point so I'll stop here.
TL;DR: Great map with exceptional atmosphere and visuals, brutal and relentless combat, but dodgy platforming, a dodgier secret hunt and a disappointing secret area that should have been a separate secret level. If you like long and hard maps, play the main level and don't bother with the 50 button hunt and you will have a good time. I'm looking forward to whatever map Mars makes next.