Three of spades - Difficulty in finding solutions.
So the formation at the tip of Mutsuki’s kagune is a pretty clear hint at Mutsuki’s card:
The three of spades. Here are some meanings and descriptions:
Difficulty in finding solutions.
Finding peace.
“ Health can be a problem for people born under this card. “
“ Doubt and indecision is the biggest bugaboo for all the 3's. “
“ However, once a 3 of Spade does make up his or her mind, they have the willpower and tenacity to abide by their decision until the very end. “
“ Three of Spades have come to labor for whatever achievement is theirs and unless they are willing to struggle for their prescribed spiritual enlightenment, they run the risk of giving up everything.”
Karmic challenge for the three of spades:” Self-protection & Transparency.
I believe all of these points quite clearly tie into Mutsuki’s narrative. For example, his/her struggle with mental health throughout the series and the myriad of issues that have come to light as the character has developed, including the murder of his/her family, animal torture, the severe abuse by his/her father and Torso’s triggering torture. Indecision about accepting his/her chosen gender and doubt if others-- colleagues, friends and family(the Q’s) would ever come to accept Mutsuki if s/he were to reveal his/her true past, actions and feelings.
Mutsuki’s willpower and tenacity clearly spun into overdrive over the wrong driving force, namely his/her obsession with Kaneki and the fact that him leaving became the epicenter of Mutsuki’s budding downward spiral. This in turn led Mutsuki to cannibalise in order to obtain enough power to stay beside Kaneki( believing it the right thing to do), and even going so far as to attack his/her family in a fit of mental instability and desperation.¨
Mutsuki’s resolve crumbled with the death of Shirazu and departure of Kaneki, believing that everything s/he had accomplished up till that point was for nothing and s/he still wasn’t deserving of familial love. Unfortunately this tunnel vision led Mutsuki to ignore the rest of the Q’s and their love for him/her, even though said love was in many ways unhealthy, and missguided.
Mutsuki right now stands on the edge of a cliff, and it’s up to especially Urie but also the rest of the Q’s to come to the conclusion that them choosing to ignore Mutsuki’s issues only served to further inflame the problem and convince Mutsuki that s/he deserves to be loved for who s/he is.