What strategies do you think standardized test makers use in selecting which multiple choice answer should be the correct one?

What I mean is, supposing the possible choices are A, B, C, D and E, do you think that special strategies are used, for example, to determine how many times the same letter will be repeated? I have seen various opinions on this. If I were making the test, I would simply use a random number generation algorithm to determine the letter choice. Anything else allows for the possibility of someone catching on to the strategy and taking advantage of it.