To create a binary tree manually, start by creating the root node with a value. Then create left and right child nodes as separate objects and assign them to the root's left and right pointers. This process continues for each node where children are needed. The code example shows creating a root node with value 1, then assigning left child 2 and right child 3. The execution table traces each step, showing node creation and pointer assignments, with the visual state illustrating the tree structure. Variables track the root and its children pointers. Key moments clarify why children are assigned separately and how the visual state represents the tree. The quiz tests understanding of pointer changes and tree structure growth.