Perhaps a plot twist could involve Naruto's parents. If Naruto is Tsunade's little brother, then it might change the story of how his parents met and what their relationship was to Tsunade. Maybe his father was involved in some sort of mission with Tsunade and that's how Naruto came to be. It would also add a whole new layer to Naruto's relationship with Jiraiya, as Jiraiya was also connected to both Naruto's father and Tsunade in different ways.
In the fanfiction, Tsunade might rescue baby Naruto from a dangerous experiment that was being carried out on him. As she rescues him, she realizes that Naruto has an extraordinary ability to resist the negative effects of the experiment. This leads her to believe that Naruto is destined for something great and she devotes herself to protecting him at all costs.
One possible plot twist could be that since they are the same age, Naruto might become Tsunade's rival in the medical ninjutsu field. Naruto, with his determination, could develop his own unique style of healing that challenges Tsunade's traditional methods. This could lead to a friendly competition between them, which in turn would force both to improve their skills and knowledge.
Perhaps a plot twist would be that there is some sort of curse associated with Naruto's lineage as their grandson. This curse could be related to the same forces that Tsunade and Jiraiya fought against in their lives. Naruto has to struggle not only with his normal ninja duties but also with this hidden curse. It could manifest in strange ways, like affecting his chakra control or making him a target for certain enemies. On the other hand, it could also be a source of great strength if he can overcome it. And there could be a prophecy related to him being the grandson of Tsunade and Jiraiya that he has to fulfill, which adds another layer of complexity to the story.
One possible plot twist could be that Naruto has some hidden Senju abilities due to his relation to Hashirama. This could change the power dynamics in the ninja world. Maybe he could use Mokuton (Wood Style) more effectively than Yamato. Another twist might be in the political arena. His connection to Hashirama could make him a target or a key figure in disputes between different ninja clans. And it could also change his relationship with Sasuke, as Sasuke might view Naruto's newfound heritage in a different light.
One possible plot twist could be that Naruto discovers some hidden power within himself related to his connection with Anko. Maybe it's a special jutsu that only their family line can use. This discovery could lead him on a new journey to master this power and uncover the secrets of their family's past.
One possible plot twist could be that Naruto's connection to Kurumu reveals a hidden power within him. Maybe it has something to do with a long - forgotten family heritage that Kurumu's family also shares. This could lead to Naruto having to master new abilities that are different from his regular ninja skills.
A plot twist could be that Naruto discovers a secret about Tsunade that she has been hiding all along. It could be something related to her family or a power she has been suppressing. This discovery could either strengthen their relationship or create a rift between them. Also, there could be a twist where an outside force tries to use their relationship to gain power in the ninja world. They might try to manipulate Naruto or Tsunade to their advantage.
One possible plot twist could be that Naruto develops a different fighting style. Since Tsunade is strong in physical combat and medical ninjutsu, and Jiraiya is a master of various ninjutsu and toad summons, Naruto might combine their teachings in unique ways. For example, he could use medical ninjutsu to enhance his own physical abilities during combat, similar to how Tsunade uses her strength. Another plot twist could be in his relationships. With Tsunade and Jiraiya as his guardians, he might have a different attitude towards the Hidden Leaf Village's elders. He could be more critical or more understanding depending on how they've influenced him. Also, his training might be more focused on stealth and intelligence gathering, skills that Jiraiya was good at, rather than just brute strength.
A plot twist could be that they are both chosen for a secret mission that only people of their age can undertake. They have to work together to infiltrate an enemy stronghold. Along the way, they discover a long - lost family connection between them. This revelation changes their relationship and makes them even more determined to succeed in the mission for the sake of their family and the village.
One possible plot twist could be that Naruto inherits some of Shisui's unique abilities. Since Shisui was known for his powerful Sharingan techniques, Naruto might develop a new form of jutsu that combines his own chakra control with the Sharingan - like skills he could potentially inherit. This would make him an even more formidable ninja in the story.