I've read a ton of these on AO3 and FanFiction.net over the years, and a few patterns definitely stand out. The most common one by far is the role-reversal, where the female Sasuke (often called Sakurako or something similar) ends up being the one obsessed with revenge for the Uchiha clan massacre. She's usually colder and more driven than canon Sasuke, while Naruto becomes her emotional anchor, trying to break through her walls. It’s an interesting flip because it plays with the gender dynamics of the original 'broody, revenge-driven' archetype.
Another huge trope is the 'team 7 but different' setup. You'll see a lot of fics where a female Sasuke changes the group's dynamic from the start. Maybe she's less openly antagonistic towards Naruto, or their rivalry takes on a more tsundere romantic tension early on. Kakashi's role as a sensei often shifts too—he might try harder to prevent her from going down a dark path, seeing a young girl heading for self-destruction.
Then there’s the soulmate or arranged marriage AU. Because she's the last Uchiha heir, political pressure for her to continue the clan leads to all sorts of plots. Naruto, as the future Hokage or just because he's a powerful jinchuriki, gets betrothed to her. These stories are full of forced proximity, political maneuvering, and the classic 'grumpy/sunshine' dynamic. The appeal is watching Naruto's relentless optimism wear down her cynical exterior.
Less common but really memorable are the time-travel or dimension-hop fics, where a wiser, older Naruto ends up in a world with a female Sasuke, or vice versa. It lets the author explore a redemption arc without the baggage of their canon history. Honestly, the best ones use the gender swap to examine themes of loneliness and legacy in a way that feels fresh, not just a cosmetic change.