Now, I know what you’re thinking. They come from the ground.
But I’m thinking a bit beyond that.
You see, the Scourge was basically a big bad Shadowlands knockoff. The Lich King was a Jailer knockoff, ICC was a Torghast knockoff, the San’layn were Venthyr knockoffs, the Val’kyr were Kyrian knockoffs. Pretty much everything else was a Maldraxxus knockoff. The Liches, the armies of the dead, the abominations, etc.
The Lich King’s greatest crime was piracy lol
But you see, Ghouls aren’t regular Undead. They are clearly mutated. Their faces elongated, their noses disappeared, their teeth much larger than they used to be, their hands increased in size and their nails grown into claws.
And yet I can’t find anything that looks remotely like that in the Shadowlands. Not in the Maw, not in Maldraxxus, not anywhere.
Sure, there are Ash Ghouls in Revendreth, but they are Ghouls in name only. In reality they are just well-done Venthyr.
So the question is: Where did Ghouls come from? Are they a Scourge Original creation? Could such a thing possibly exist?
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Hee Hee such a cute little ghouly… wait what was the question again?
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When a mommy ghoul and daddy ghoul love each other very much…
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They also have a weird mix of various races. like Saurok claws, kobold looking head.
I’d say the Azerothian ghouls being weird and mutated is a side-effect of being infected by the Plague of Undeath, considering it was shown to melt faces that one time during Wrathgate.
Also, the Plague of Undeath was home-grown on Azeroth by the Forsaken Undead (i think), so yeah, these ghouls are a certified Azeroth classic.
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Certified Azeroth Organic by the R.A.S.
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From the Arabic folklore if my old D&D memory still serves me sometimes.
Mutated Grain, then perfected afterwards.
I’d like to think of Ghouls as “Bone Elementals”, like rocks, fire, water, etc. But these elementals just stick to bones instead.
So that would make all necromancers Bonebenders! Which sounds kinda gross, but I stand behind this theory 13%! 
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In other works of fantasy a ghoul is often a former human that due to either desperation or madness took to eating the flesh of zombies/dead people and the diet gradually…changes them.
The Lich King did have a number of dead and living necromancers working for him to create new weapons. So it is possible that they came from that. Or we haven’t encountered the specific realm of Shadowlands they come from. There are supposed to be thousands of different realms in the dimension of death. We’ve encountered 5.
I can see it now. Ghouland. The land of the Ghouls. Where everybody is damned to live eternity as a Ghoul.
But at least nobody there is lonely because everybody got Ghoul friends 
There could be a land out there for the mindless raving lunatics of all worlds to go to. No order. No structure. Just packs of ghouls ripping each other apart for eternity.
Iirc, there was something akin to that in the WC3 manual.
EDIT:
"Ghouls have the appearance of a bent, twisted humanoid figure. Much of their flesh has rotted away, exposing a fair amount of bone and twisting facial features until they are unrecognizable as human. As undeath progresses in a victim, it twists and corrupts the body, growing fangs and claws.
Only the Scourge and a few other necromancers know the secret of creating ghouls. Death knights have raised ghouls to their will to fight alongside them as well. "
That’s from Wowpedia.
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I am convinced Arthas was a genius before his time. Azeroth’s greatest plastic surgeon.
That or these are malformed peons and peasants.
