One possible plot twist could be that Orochimaru has a new jutsu that Naruto has to figure out quickly to save Sakura. Maybe it's a jutsu that messes with time, so Naruto has to break through different time loops to reach Sakura. Another could be that Orochimaru has an unexpected ally who tries to stop Naruto from rescuing Sakura. This ally could be someone from Naruto's past who has a grudge against him.
Naruto would likely become more determined and strategic. Having to save Sakura from Orochimaru would make him realize the importance of being more than just brute force. He might start to study Orochimaru's techniques more carefully, which would increase his knowledge of different types of jutsu. This would also make him more respected among his peers as they see his growth in handling complex and dangerous situations.
It shows the strong bond between the two brothers. Despite all the complications in their relationship, Itachi still cares deeply for Sasuke and is willing to risk a lot to save him from a great danger like Orochimaru.
One scenario could be that the bullies are picking on Sakura at the ninja academy. Naruto arrives late and sees what's going on. He immediately challenges the bullies to a sparring match, which they can't refuse because of Naruto's status as a top student. During the match, Naruto easily outmaneuvers them and makes them look foolish, causing them to run away in embarrassment.
Kabuto is also common. He was Orochimaru's right - hand man. In fanfiction, he could be used to either further Orochimaru's plans against Naruto or he could have a change of heart and help Naruto against Orochimaru. His medical skills and knowledge of Orochimaru's secrets make him an interesting addition to the story.
Sasuke could save Sakura from Orochimaru by outsmarting him. Since Sasuke is very intelligent, he might come up with a clever plan to get Sakura away from Orochimaru's clutches.
Well, if Naruto saves Hinata from Orochimaru in a fanfic, it might start with Hinata being captured by Orochimaru's minions. Naruto would immediately go on a rescue mission. He'd probably fight through Orochimaru's various snake - based defenses. And when he finally reaches Hinata, he'd defeat Orochimaru with a powerful Rasengan, and then carry Hinata to safety.
Well, in such a fanfiction, Sakura being Orochimaru's apprentice could lead to some really interesting character developments. For one, Sakura would likely gain a darker and more ruthless edge to her skills. Orochimaru is known for his unethical experiments and dark jutsu. Sakura might learn some unique medical ninjutsu from him that goes against the normal ethical boundaries in the ninja world. It could also put her in a conflicted position with her former teammates, especially Naruto and Sasuke. They might view her new association with suspicion and it would create a lot of drama and tension in the story.
In this fanfic, Sasuke could sense Naruto was in a dangerous situation with Sakura. Maybe Sakura, under some dark magic influence, was about to harm Naruto unconsciously. Sasuke, with his quick reflexes and strong power, rushed in between them. He used his Sharingan to break the magic's hold on Sakura and saved Naruto. Then Naruto and Sasuke had a moment of understanding, looking at each other with a new level of respect and friendship.
Perhaps in this fanfiction, Naruto has some sort of special power or transformation that he unlocks just in time to face Orochimaru. It could be related to his Nine - Tails chakra in a new and unique way. He uses this power to break through Orochimaru's defenses and save Hiruzen. Naruto might also use his knowledge of Orochimaru's weaknesses that he has learned either from Jiraiya or from his own past encounters with Orochimaru's minions.