CEO’s aren’t necessarily assholes. But what they are are people who focus on the needs of the business over everything else. They care about people who can execute their vision. If an employee is not on board, then that employee is out the door.
For instance, it’s like if you had a house cleaner. You’re the CEO of your house and you have an idea of how clean the house should be. The purpose of the cleaner is to make the house as clean as you want it. If the cleaner’s view of a clean house doesn’t align with yours, you’d fire the cleaner and find one who could deliver your vision of what a clean house should be. However, that doesn’t mean you have to be an asshole to the cleaner. You can still treat them with respect. But to take this further, some people don’t have the skill to fire the cleaner. They may feel anxious or guilty about firing them, so they just let the cleaner do whatever they want. Or they make up some excuse (e.g. “I can’t afford it”) to avoid confrontation. A CEO wouldn’t care about that kind of stuff. They would say “Clean it this way or you’re fired.”
Someone who also accomplished many breakthroughs as CEO is Steve Jobs. From many stories I’ve read, it seems like he was not fun to work for. He wasn’t necessarily an asshole, but he didn’t really care about how the employees actually felt. If he wanted the Mac bootup time to be quicker, he demanded the engineers find a way to make it boot quicker. If he wanted the colors on the phone screen to be more accurate, he scrapped the prototypes and had the engineers find a way to make the colors better. If he wanted the glass to be more scratch resistant, he delayed production and tasked the engineers to find better glass. If the engineers didn’t feel like doing all that extra work, oh well, too bad. Either get it done or find another job. And it’s not like Jobs was solving any of these problems himself. He just said “I don’t like this. Make it better”. He wasn’t actually down in in the lab with a soldiering iron patching motherboards to fix things.
I think Musk has that same kind of skill and ability like Jobs to force his vision to be executed. However, he is also a total narcissistic asshole in addition to having that skill. CEOs don’t have to be as big of an asshole as Musk, but it’s easy to see how they can be.