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Belatedly:

This post gained a lot more traction than expected, so quick edit: the “canon” discussed below is only my personal interpretation of canon, and this post is definitely not intended to be a guide for characterizing Shigaraki in every fanfic! Please don’t use this meta to criticize anyone else’s writing, as that was not my intention. Everyone should feel free to create what they enjoy! 

Look y’all, I ain’t one to judge, but I love canon-based fics and sometimes the massive gap between Shigaraki in fanon and Shigaraki in BNHA’s canon just has me going whaaa???

I mean, like…

Fanon Shigaraki: Abhors all human contact. Lurks in his bedroom 24/7. Never speaks to others except to bitch them out. A vampire who will combust upon setting foot outside his lair.

Canon Shigaraki: Seen alone in his bedroom a grand total of one (1) time in the series; the only other time his room is shown, the rest of the entire League is squeezed in there too. Never out of contact with his followers except Dabi who is the real antisocial bitch here. Longest he’s ever been drawn spending time by himself without another major character to keep him company? Two pages. Gets mad… GOES TO THE MALL.

Originally, Horikoshi never wanted to do Villain profiles. He wanted the Villains to be scary. Maybe he always intended death to be the answer to them, even as he expanded on their backstories.

In an old interview from 2018, when asked if Shigaraki is a villain who should be saved, Horikoshi does answer 'yes', but then follow it up with: "I think that we have gotten to the point where Shigaraki can no longer turn back though."

Movie 2 ending - which Horikoshi said was the ending he originally planned - has Deku and Bakugou punching Nine (pseudo-Shigaraki) to death-as-they-know-it.

Once again, technically, Shigaraki's heart was saved. Deku smashed his hatred. Deku took Tenko's hands. Unfortunately Shigaraki didn't immediately convert to Heroism and still wanted to fight for the League - point where he didn't turn back - so Deku gave up trying to save him physically.

A few weeks before, I thought that Horikoshi just got tied and wrapped things up in the quickest and sadly weirdest way possible. I still am willing to allow that, but ever since Horikoshi started Act 3 three years ago, he never actually wrote Heroes giving the Villains' grievances any serious consideration until it comes out during the confrontation and the Heroes giving a few words towards it at best, and at worse, not even knowing the problem (quirk counseling, Tenko's Walk). He let Uraraka and Deku still adhere to insisting on practically dehumanizing their opponents/Villains the day before the final battle (probably so that when Uraraka and Deku realize they still can't ignore the pain they see in their Villains and finally reach out a bit, that's the height of compassion and heroism.)

But really, sorry not sorry to sound like a broken record, Act 3 had Deku acting like a dipshit the entire time. He says he wants to save The Crying Child he saw inside Shigaraki's heart, and not necessarily Shigaraki the person, and never actually takes killing off the table. He only vaguely keeps up this idea. He never reveals this desire to anyone, never involves his friends or adults in this plan. He doesn't even have a concrete plan, and all he never did was just to keep punching Shigaraki to kingdom come. He never actually protested when Gran Torino told him he should kill Shigaraki, he never opposes the creation of a battlefield called "Sky Coffin", he does not speak up when the Heroes says they prefer the AFO persona to be in possession of Shigaraki. During their whole fight, Deku barely talks to the guy.

The best Deku ever does is to hold back on giving Shigaraki an annihilation blow until he could find out why The Crying Child was crying, which he does by literally smashing into Shigaraki's core to pry his trauma open. And even then, when Tenko is spilling out his guilt and grief that he killed his family, as well as his fears that his existence is cursed, all Deku has to say is "Well, holding hands feels nice, so I'm here." I get that's supposed to be like, Deku accepting Tenko despite Tenko having a deadly quirk and blood on his hands, but come on. As an act of Greatest Heroism that it's supposed to be, that's so... low bar, to put it mildly.

(Then when Shigaraki gets repossessed, Deku gives up any thinking on saving Shigaraki, and then readies up the annihilation punch. Volume release even expands on just how much power and preparation Deku is using to smash Shigaraki's body to pieces. There's no intent to figure out if Shigaraki is still there to bring back or minimize harm to Shigaraki's body so there's something left after AFO is gone. It's not an accident. Deku fully goes in for the kill.)

It all feels like truly saving Shigaraki - from possession, from AFO, from his distorted worldview, from a Hero System that hurt his friends, from his belief that the world isn't worth preserving - just wasn't a real goal for Deku. Never was, in Act 3. He wanted to understand The Crying Child and give some relief there, but that's it. Like exorcising an evil spirit and then forcing them to move on, never actually wanting the spirit to remain and continue existing - because there's no place for them in this world. (Which is why Deku also never has a vision for what comes after, for Shigaraki. Shouto wanted a meal with Dabi, Uraraka promised her blood to Toga, but Deku? Nothing.)

Overall, the ending actually does fit Deku's writing in the last act. He wants to save the ghost of The Crying Child but nothing else. He expands minimal effort in actually connecting with Shigaraki the adult man. He has no interest in addressing Shigaraki's grievances (nor in also saving the rest of League that Shigaraki is doing all this for) (and also it turns out Shigaraki's grievances aren't real because AFO made most of them up). His strategy is just to beat up Shigaraki until Shigaraki throws up his trauma.

Adding to that, Deku's last words to a dying Shigaraki is that he can't forgive him, so basically he's considering Shigaraki as having past the point of return - exactly as Horikoshi stated in his interview. There might be something to Deku regretfully telling All Might that he couldn't save Tenko's life, but when he follows it up with "Even after I smashed his hatred, he still wanted to stay the League's leader," that really can't be anything but Deku basically putting some of the blame on Shigaraki, for not ditching his friends (who, to Deku, apparently don't deserve to be saved alongside Shigaraki). Sticking with the League is being past the point of turning back... which is the same conclusion Hawks comes to with Twice, in Act 2 (...so it seems that's been there all along.)

The ending fits Deku's writing - and overall - in the last act (and even before that.) Deku's utter non-progress fits Shigaraki's conclusion. His half-hearted actions made sense and so of course led to his final battle of just giving Shigaraki a giant Smash (but with pity and some sympathy, because he's not an cold killer but a Hero who can even spare emotions towards a monster).

Hello anon, thank you for your ask! 

I will try to answer your questions the best I can, however beforehand I think it’s important to note that I don’t really like diagnosing characters outside of like specific examples where the authors tell us this is the disease they were attempting to portray, or headcanons. Shigaraki clearly shows signs of mental illness, but I don’t think Horikoshi writes characters by looking up a list of symptoms in the DSM and then writing them based on that. 

Also yes, the two clearest examples of mental Illness (Shigaraki, Twice) are both villains but I have faith that the mental illness of Shigaraki is an instance where it’s used to humanize him and show how much of a victim of a system both characters are, rather than just to give the villain traits that are abnormal and therefore creepy and dangerous. 

I can’t give you a specific dianogisis but I can give you a more in depth look at several symptoms that Shigaraki displays. 

Excoriation 

Excoriation disorder is an obsessive-compulsive spectrum mental disorder that is characterized by the repeated urge or impulse to pick at one’s own skin to the extent that either psychological or physical damage is caused. In Shigaraki’s case it’s clearly a stress response that is aggravated the more violent, unstable or dangerous a situation he is put into. 

Which is why I find claims that Shigaraki is content with violence, or likes being a killer and is comfortable living this way to be false. Because Shigaraki’s own body constantly rejects him. He feels a compuslive need to scratch and harm himself because his body cannot handle the stress of being violent. It’s a stress response because Shigaraki does not actually on some level want to be doing these things, and living in a constant state of stress and harm makes him more compelled to vent his stress by following his compulsions. 

The compulsion he feels can sometimes get so bad that in childhood he was rolling around the floor, crying and frantically scratching his whole body. This is not what All for One said and him holding back his urge to kill, but rather Shigaraki responding to the stress. Shigaraki is seven and was put in front of two homeless people who were threatening to harm him and he already came from a physically abusive household. He’s in unbelievable stress with no healthy way of venting it, and thereofre he compulsively self harms.