Framed as a (thankfully fictional) documentary, The Medium follows a film crew to a small town in the Isan area of northeastern Thailand, where they meet a shaman named Nim (Sawanee Utoomma).

Troy Baker has discussed his role as The Maw in The Medium, a malevolent entity stalking the game's heroine Marianne, saying it's a character type the popular voice actor has never played before in his career.

Both the mobile and browser versions of the game use bots for the opposing "players", but a real live multiplayer version exists called Paperio live.

paper.io has been exposed multiple times for being a fake multiplayer game! Yeah, that's right, you've been fighting against noob bots all along... You can turn off your WiFi and still play the app.