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It is unknown how Sweet Tooth was able to conjure a group of numerous followers. However, as stated by Calypso, they were each dedicated to serving Sweet Tooth, as they believed he was a "god" and "king."
The Clowns, as a cult, appear as the main opponents in Dollface's story and end as the final boss of her story, controlling Sweet Tooth's Carnival of Carnage.
The Clowns' GunnerIn Sweet Tooth's story, Sweet Tooth is only accompanied by one member of the Clowns, a man with a worn out tank-top and a clown mask with a long nose, with a deep New York accent. This clown seems to be Sweet Tooth's most trusted member of the cult, considering that he has earned enough of Sweet Tooth's trust that he is able to drive with him in the shotgun of the Ice Cream truck. He also seems to be very respectful of Needles, referring to him as "boss" whenever he speaks to him, and by assisting him in his hunt for his daughter, Sophie Kane. They have a mutual trust with each other, as evidenced during their fight against The Brothers Grimm; however, Sweet Tooth destroyed that trust when he left his fellow Clown to die and detonated the explosive charges the latter planted inside of Hammerhead/Slayer.
Other members of The Clowns were proficient in vehicular combat, and, seemingly, had each devoted their skills to learning to build and control a Sweet Bot of their own, just as Sweet Tooth had.
After Sweet Tooth's death at the hands of Calypso, The Clowns became far more dedicated to keeping his memory alive. Some Clowns created masks that looked similar to Sweet Tooth's original mask. Others looked like generic clown faces, and some even looked like classic iterations of Needle's person from older Twisted Metal games. Many of these Clowns became proficient in on-foot assaults, especially with chainsaws. They were masters of boarding vehicles and ambushing in groups of large numbers.
This is the four-stage final boss in Dollface's story. It is a memorial built to Sweet Tooth; when he died the clowns became obsessed with preserving his memory of him alive, and believed he would rise, stronger and madder than before. As its name implies, this boss is thematically carnivalesque and brutal.
- When playing as The Clowns in Axel or Reaper, Needles drives the vehicle alone. However, when the player performs a successful point-blank shot with the Shotgun, the Clowns' gunner can be heard saying, "Right in the face, boss!" despite only Needles being the driver.
- In the Story Mode, Needles was supposed to sacrifice his gunner when he planted C4 on one of the Brothers Grimm. Because of this, he will disappear from the player's car after the explosive is detonated. However, if a gunner-activated weapon is used (such as Swarmer Missiles), the gunner will re-appear in the car to use the weapon, and will later show up in the passenger's seat again next to Needles, after the boss battle. This is merely a gameplay mechanic.
- Due to its large size, the Clowns' Nuke statue is much easier to hit than the Dolls' statue.
- Early beta designs of the Clowns' gunner had him wearing the same appearance as Needles, with suspenders. His final design incorporated the polka-dotted pants and enlarged boots, but traded Needles' suspenders with a worn-out tank top.
- The Clowns owned their own version of Talon which was covered in pink polka-dots, much like Sweet Tooth. Dollface later comandeered this vehicle to destroy Sweet Tooth's Carnival of Carnage.
- This version of Talon can be accessed if the player equips the "Sweet Tooth" paint job to Talon.
- At first the Clowns were one of the two factions used in the online Twisted Metal team games, the other being The Dolls. However now The Skulls and The Holy Men can be used in ranked matches.