If an absentee ballot is unfolded, that means the voter cast an absentee ballot in the clerk’s office on a piece of voting equipment known as the ES&S ExpressVote. The ExpressVote is a touch-screen ballot marking device (BMD) which prints the voter’s choices on a smaller paper ballot which does not need to be folded. ExpressVote ballots can be counted using the ES&S DS200 precinct scanner, just like regular sized paper ballots. ExpressVote BMDs are also used by people with disabilities to vote in person at polling places.
The clerk or deputy clerk is required to initial the absentee ballot before issuing it to the voter, so it is natural that many of them all have the same set of initials. More info about initials in this FAQ.