The honest answer is mostly because you are seeing bad photos of him, since Lemmy loves to hate on him and all articles hating on someone love to show bad photos. If you look up positive/neutral articles he looks much better.
You mean older photos? Publicity photos? This is the equivalent of “you have been fooled by the media into not liking Trump/musk/whoever!”. For one, this is the photo from the BBC article, not one selected by someone on Lemmy. Then, anyone who watched the video of his ‘interview’ last week can see for themselves he’s looking much worse than he did a couple years ago, and fairly terrible overall.
For me, it just looks like he has a certain coldness in his eyes. It's not a dead or vacant look, it's just the way a smile, or any other facial expression for that matter, just doesn't seem to make it to his eyes. There's obviously life and intelligence there, but it's not a friendly intelligence. I pulled up the most lizard-man pictures of Zuckerberg for comparison, and even at his most robotic, his eyes still look human. Like there's some capacity for empathy in there somewhere. With Musk? His eyes just don't quite read as human to me in an uncanny valley sort of way.
It doesn't help that he's got this vibe undulating off him, you know the one-- evil, narcissistic, oligarch dork, trying to look cool but failing miserably because it's impossible to be cool when you're anywhere remotely close to as big of a dickbag as he is.