Louise was a pretty shy woman, a contemporary said it was very difficult to have a conversation with her because she was a really reserved woman. Anyway Louise as Queen we can work with 2 scenarios.
Her husband the Duke of Fife died in 1912 OTL - If with Louise Queen he died at the same time she would have reigned with a consort for only two years, certainly in the same style that George V did, with the duke's death she would surely follow the and he would stay away from the court and would do what was most necessary, while Alexandra would certainly be the one to play more roles in the royal family, followed by Maud.
If the duke survived until the 1920s or 1930s we might have a more active and participative Queen, since her husband might have worked as an incentive for the Queen, Alexander was rather interesting, I believe.
Some questions that I imagined =
during the first world war would the royal family have assumed the surname macduff / fife or would it remain Windsor?
Had your daughter maud inherited the Duchy of Fife?
Louise being heiress in 1892, with only one daughter (Alexandra) would have assisted in a possible marriage to Toria, since she would be 4 in the line of succession?
Some sources have already stated that May of Teck did not authorize the Russian imperial family to gain exile in England, in a scenario that May is not the Queen consort, and Louise and Queen would have a chance of the Russian royal family exile in London after the revolution?