Considerable progress has been made in predicting nominal NVH behavior in electric drivetrains, but the acoustic scatter observed across manufactured units remains insufficiently understood. In practice, nominally identical drive units may still exhibit noticeably different tonal behavior because small deviations in gears, shafts, bearings, fits, centering features, or assembly phase modify the excitation, transfer, and radiation mechanisms of the system. This review examines how manufacturing and assembly variability influences NVH performance in electric drive units and e-axles, with particular focus on the rotor–shaft–gear–bearing–housing system. Unlike broader EV NVH reviews, the present work focuses specifically on variability-induced acoustic scatter and its propagation along the drivetrain NVH generation and transmission path. To support transparency and consistency, the literature search and selection process followed a structured, PRISMA-inspired approach to ensure transparency and consistency across Scopus, Web of Science, Google Scholar, and SAE Mobilus for the 2015–2026 period. From 387 identified records, 50 studies were retained after duplicate removal, screening, and full-text assessment. The selected literature was synthesized into eight thematic categories: imbalance; run-out and eccentricity; bearing clearance and preload; spline and pilot centering; thermal effects; phase indexing; transmission error and sidebands; and end-of-line NVH diagnostics. The reviewed literature shows that manufacturing- and assembly-induced deviations can significantly alter transmission error, sideband structure, shaft-order content, and final tonal response, even when individual components remain within nominal tolerance limits. Beyond synthesizing the evidence base, the review proposes a general simulation methodology for variability-aware NVH prediction based on explicit deviation parameterization, hierarchical model fidelity, intermediate excitation metrics, thermal-state awareness, and closer integration with production and measurement data. Overall, the findings support a shift from nominal NVH assessment toward robustness-oriented, production-representative prediction of acoustic scatter, and establish a structured methodology for variability-aware NVH engineering in electric drivetrains.