Originally Posted by
TheKeeper
...Question is, what do we order? First timers, so we'd like to know what are the must haves.
Unlike many/most burger chains, In 'N' Out's menu is utterly simple and has changed very little since it's founding: hamburgers/cheeseburgers (+veggies for topping), fries, shakes/sodas.
Whatever is ordered from the regular or "secret" menu is simply variants on this simple theme.
Originally Posted by
TheKeeper
...So literally, there is no other way to get an in n out burger with other ingredients on it? Only real options are lettuce, tomato, onion and cheese?

See above
Part of In 'N' Out's success is attributable to its single-minded focus on simplicity (that's hardly the only reason, but it's an important one).