Namechanged for this because it's slightly embarrassing but I have a perspective you might find interesting. I'm an autistic woman and when I was growing up I was interested in make-believe and imaginative play for a lot longer than most people. I didn't really grow out of it. This was pre-internet and I loved playing pretend games with younger siblings.
When I got to about 12, I was having a truly horrendous time - socialising becoming more complicated and me failing to grasp it, puberty, family issues. I developed an intense interest in some of my imaginative play ideas, including mythical creatures. I started saying I was one of these creatures, and if someone said that I wasn't, I'd either ignore them or contradict them. Let's say dragons.
It got to the point where I was being told 'you're not allowed to mention dragons at Aunt Gertrude's house' which as an autistic girl I thought was horrendously rude and unfair since Aunt Gertrude had topics of conversation I didn't like much but I knew you couldn't just forbid people from mentioning things. In hindsight I think my parents were a bit embarrassed about it. I was oblivious and had no idea how weird it came across. Very emotionally immature, probably.
Mentioning dragons to Aunt Gertrude was actually a very good thing for me to do because she let me know that she was concerned about me and asked me if I really thought I was a dragon. Seriously, not laughing or mocking or getting angry over it. So I said no. No, of course I knew I wasn't. The whole thing was a big game that I probably withdrew into because of how hard I was finding everything else in life, and saying I was really a dragon was refusing to 'break character'. She talked to me about how there are times it's fine to play games like that but it worries people if you do it all the time. Really got through to me.
I don't think I ever really grew out of wanting to play make-believe but now I channel it by writing fiction and don't go about pretending to be anything. I'm aware of what's socially appropriate! At 12 I didn't know, or didn't care until I saw that it had made someone I cared about feel worried (my parents getting angry about it made me more determined to insist I was a dragon, because it became a power struggle).
I'm very glad the modern internet wasn't around then. If I'd had adults telling me I really was a dragon in a human's body and that's why I felt that way, I could have ended up genuinely drifting away from reality instead of just playing a game. My mental health was already bad and that would have made it worse.