I love reading peoples thoughts on this -great thread.
So, I listen through a few times and then let my brain visualize some sounds and passages before tinkering on the fretboard usually.
I don't typically let scale pattern option under the chords lead my approach, which honestly makes me less spontaneous with sounds when playing with people, but ultimately I think it makes me more creative because I'm building sound ideas internally and then applying them to where I know they can exist on the fretboard.
Because of this, I'm great in the studio with interesting ideas, but also not as good at wanking for long periods like I'm some kind of virtuoso type player with solos