It's all about the monetization!
For some webmasters it's the most lucrative to sell the traffic to an adnetwork like Exoclick, but for others it can be interesting to send it directly to a CPA network. As I am' from Traffic Company (a CPA network) I would love to say that that is always the best option, but it isn't... You really need to test it. If you could filter, it can help you to make a split for example. Some geo's and some devices you send to an adnetwork and the rest to a CPA network.
It's all about testing and optimizing here. I wish it was simple and one answer will do the job, but it isn't :-(
But the one who does this the best, is the winner in the end :-)
If anybody have questions, let me know! Monetization and making money out adult traffic is my core business!
Cheers!
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