The cult leader and mass murderer didn't actually appear himself, although Twitter would certainly like Evan Peters to play him. Instead, the show channeled Manson's legend into the episode, which introduced the backstory of the Roanoke house and two murderous sisters, Miranda and Bridget Jane, who lived in the house in the late 1980s. You might remember them as the two women Shelby seemingly hallucinated during her wine haze in the season premiere.
Well, they were no drunken nightmare. They were nurses who ran an assisted-living facility in the house decades earlier. When they weren't busy doling out medication, they were killing patients using means such as rat poison, bullets to the head, and suffocation.