Was the Queen an ascended nerubian? We see a lot of them are very humanoid but a few are fairly monstrous. What did she not ascend? She seems the same as she was in the intro video.
https://warcraft.wiki.gg/wiki/Ascended_nerubian
Queen Ansurek herself appears to also have been modified slightly, being granted additional legs and a humanoid half that is more akin to the Ascended rather than how she was beforehand, though she is still referred to as a nerubian queen.
So at the very least she could have modified herself.
Now as to why she didn’t fully ascend? It’s possible that she was aware that Xal’atath could seize control of the Ascended and decided to not risk it happening to herself.
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She definitely had something happen. In the 2.5D cinematic showing her betrayal of her mother, she goes from having a more alien, buggy facial features at the beginning to having a basically human face after she becomes queen.
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I assume it has to do with the threat of losing pheromones. 
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During the fight she talks about her coming ascension. I think the idea is that she’s on a much longer ascension “track” - the lesser Nerubians are being turned into shock troops, but she wants to become some kind of god, so her path is much longer and more complicated.
When we meet and kill her, she’s partly ascended towards being something much scarier.
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I doubt it since they didn’t do any for Dragonflight’s end of raid bosses but imagine if Ascended Ansurek is a mythic only phase.
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I reckon its more like, she didn’t want to undergo a risky precedure completely, She saw what it did to her mother and how the shock troops have no pheromones, we also see more dangerous forms as time goes, she’s likely just letting others take the risks until she can have it done with no drawbacks
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