It means 'crazy' or 'psychopathic'. It's when a person who seems sane on the outside is actually hiding her inner self who is actually bat shit loco.
That girl is vats I swear to God, she wants a AK47 for her 23rd Birthday.

Man you've got to be vats to think I'm going to jump without a parachute.
by Davvey July 8, 2017
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