In her original appearance, Lilith's standing as Andariel's mom brought her an appearance similar to Diablo IV Gold the Maiden of Anguish. The Sin War books described her as with a rather reptilian appearance.

Prior to D4, Diablo 3 and Book of Tyrael's designs of Andariel have given Lilith a mix of Mephisto and Andariel's attributes. In turn, Lilith's final layout in D4 gave her skeletal webbed wings which accompanied the bone-like exoskeleton that wraps around her body. True to her matron title, the final layout for Lilith also sported a dark gown.

Perhaps most interesting about Lilith's origins would be her familial relationships. Most notable would be her standing as the Daughter of Hatred, based from her parent, Mephisto, the Lord of Hatred.

Contrary to the rebellious Lilith, the lore clarifies Lucion as an extremely obedient follower of Mephisto, majorly from fear. Regardless of his brutality and hatred, Lucion's facet of hatred"paled" in comparison to their father's. Additionally, Lucion and Lilith were implied to have been exceptionally close.

Lilith had experienced changes in her familial ties between her first appearance in Diablo 2 and her eventual return in Diablo 4. However, the retcons would change Andariel into a Lesser Evil and buy Diablo Immortal Gold one of the heads of Tathamet, the first Prime Evil. Subsequently, this could transform the boss Andariel to the aunt of Lilith, seemingly reversing their functions.