Making any sense of this meme whatsoever requires having knowledge of the video game Metal Gear Solid V: The Phantom Pain (2015). Without that, it is just Trump's face overlaying some video game character.

At the end of the original Metal Gear (1987) video game, the player character, Solid Snake, defeats the final boss, a body double of long-time series protagonist Big Boss.

Who was this body double? MGSV: TPP, chronologically prior to the latter game, tells us this story. There are numerous interpretations, but the following is the mainstream interpretation.

Before the events of MGSV: TPP, Big Boss had gone into hiding. The Medic from the end of MGSV: GZ, who has been in a coma, is misled into believing that he himself is Big Boss, going under the code-name 'Punished "Venom" Snake'. Eventually, he realizes that he is indeed not Big Boss, but the Medic.

With the benefit of hindsight, we now realize that in Metal Gear, Big Boss sent Solid Snake, his clone, to eliminate his own body double, Punished "Venom" Snake. He always viewed Venom as dispensable if not necessary to dispense with at some point, and, presumably, then seized control of the organization that he and Kaz built and integrated it into his own.

(This interpretation actually makes little sense once you've actually played the game to the end of level 46 as a thinking person. The game is full of symbolism: notice that this very meme, which is a frame of a cinematic right before the game's end, is full of "smoke and mirrors": something intended to disguise or draw attention away from an often embarrassing or unpleasant issue. There are numerous other reasons to believe that level 46 does nothing other than replace one lie with another. Personally, I didn't believe that Venom Snake was the Medic, I believed that Ishmael was the Medic and that Venom was someone else entirely. Just to take one of many examples of why nothing is as it seems: why does the passport that is supposedly Venom's have a stamp for 1978—that is, during the time that he was in a coma—and for August 1984 when levels 1/46 supposedly take place in March 1984 according to the calendar next to the hospital bed at the start? Even if Ocelot gave him a fake passport made up for him, surely it would be easily detected as fake by the authorities with that August 1984 stamp on it. I took a lot of interest in the oddities of this game's plot at the time I completed the game [over seven years ago, now], and have plenty of arguments to make against the mainstream interpretation that the story gives you. Ishmael as the Medic, Ishmael as a hallucination, and Ishmael as Solidus Snake are all heterodox interpretations of Ishmael that I find plausible. Venom Snake as the Medic remains plausible, but Venom as another, almost hidden MSF soldier who is very easy to not notice in the helicopter destruction scene at the end of MGS: GZ is a plausible heterodox interpretation of Venom. My personal conclusion: Ishmael was the Medic, Venom Snake was the almost hidden soldier on the helicopter.)

Next, is there really any similarity between Venom Snake and Donald Trump? I'm not seeing any clear parallel, except that both men have been through a lot of suffering and torment and survived a lot of dangers.

A more conspiratorial-minded interpretation: Venom and Trump have both been used and have both outlived their usefulness to those using them?

Another parallel: Venom Snake and Trump cannot trust anyone. Of the two who seem to be Venom Snake's allies, Ocelot regains his memories and remembers that Venom is an expendable body double over whom he prefers Big Boss. When Kaz also learns of Venom Snake being a body double, he becomes hostile to Big Boss and becomes only interested in Venom Snake as an instrument to get revenge against Big Boss for his being duped. Eventually, both men abandon Venom Snake outright. Similar thing with countless people that Trump probably once trusted, like Cohn and Pence, who have all abandoned him. Can Trump really trust Vance... or, for that matter, even his own children?