During an interview with Billboard, Fusari recalls the meeting with Gaga, Vincent Herbert, and himself that they had with Jimmy Iovine, the CEO of Interscope Records:
Anyway, Jimmy Iovin listens to a little bit of “Dirty, Rich” and to another record Stef [Gaga] and I did called “Sexy Ugly”. He stands up, looks at Vincent Herbert and says, “Let’s give it a try.” And that was it. She got a deal.
It was also mentioned in the June 2009 issue of Rolling Stone with Gaga as "Ugly Sexy". The concept behind the song might be related to the following quote from the article .
I think I look new. I think I'm changing what people think is sexy."
During her performance at Glastonbury in the UK, she performed a section of this song as an interlude before "Just Dance".
During the second leg of The Monster Ball Tour, a neon sign with the words "Sexy Ugly" is used while Gaga performs "Just Dance".