Try rebooting pc, what are you running Windows 7? What graphics card? Try re-downloading the game then rebooting, or try patching the game with IO-HF_Patch-1.0.zip then the game Insult Order English Launcher.exe should run after doing a clean reboot just in case after patching.
Maybe your game was patched incorrectly, or it patched it wrong somehow, either way if it works with IO.exe which I think is the game's base EXE then all is well. Maybe your launcher.exe was moved and you ran it from another location? Could try moving it back to the game's outer directory just within INSULT ORDER ver.1.04 [English-Uncen] whilst IO.exe is in the GameData folder.
If i remember correctly you can get anal in almost every position.
Try right-clicking the dialogue box, and check? Otherwise, it should be set to a scenario I think you have to play the whole thing to save scenarios, it doesn't save during gallery mode as far as I know saves the last scene used. I personally didn't bother playing this game.
Let me know if you figured out a solution. I think when this released, the focus at the time (VR) was via Windows Mixed Reality
