The first character I saw them with was a Khajiit mage, likely somewhere around lvl 10(though I don't know if they only spawn past a certain level). Even when I first heard that sound, I felt like a cub at the moment, no spells, no staff, no weapons. The character had already been through the Kvatch quests(with MMM amping up the spawns in some places), and this had me wishing I had a tail to put between my legs.
Although, I have yet to see the infamous creature that the mod adds to the gates. Given that I have seen the Lesser versions, and how much time it took to deal with those(when not with powerful weapons/armor), I'll probably be sweating if I ever do see one. Of coruse, when I first encountered the lessers, I thought the sound was from the actual thing.
Most of the creatures MMM adds are startling, if nothing else(although some of the more higher level ones I haven't seen yet). However, the one instance I jumped, was probably with one of the obvious vanilla creatures. The Land Dreugh. I think I might've heard about it previously, but not really seen it outside the game.