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Very little is known about Koakuma, and unless she makes another appearance she may remain a mystery. What is known is that she's seen around the library of Scarlet Devil Mansion during the events of Embodiment of Scarlet Devil. Apparently she lives in the mansion. Her exact role is difficult to tell, but she is believed to be an assistant in Patchouli's library there, due to being the midboss of her stage.
- The name Koakuma means "small" (小) (ko), "bad, vice, rascal, false, evil, wrong" (悪) (aku) and "witch, demon, devil, evil spirit" (魔) (ma).