V605 Aquilae is today widely assumed to have been the result of a final helium shell flash occurring on a single-post-asymptotic giant branch star. The fact that the outbursting star is in the middle of an old planetary nebula and that the ejecta associated with the outburst is hydrogen deficient supports this diagnosis. However, the material ejected during that outburst is also extremely neon rich, suggesting that it derives from an oxygen-neon-magnesium star, as is the case in the so-called neon novae. We have therefore attempted to construct a scenario that explains all the observations of the nebula and its central star, including the ejecta abundances. We find two scenarios that have the potential to explain the observations, although neither is a perfect match. The first scenario invokes the merger of a main-sequence star and a massive oxygen-neon-magnesium white dwarf. The second invokes an oxygen- neon-magnesium classical nova that takes place shortly after a final helium shell flash. The main drawback of the first scenario is the inability to determine whether the ejecta would have the observed composition and whether a merger could result in the observed hydrogendeficient stellar abundances observed in the star today. The second scenario is based on better-understood physics, but, through a population synthesis technique, we determine that its frequency of occurrence should be very low and possibly lower than what is implied by the number of observed systems. While we could not envisage a scenario that naturally explains this object, this is the second final flash star which, upon closer scrutiny, is found to have hydrogen-deficient ejecta with abnormally high neon abundances. These findings are in stark contrast with the predictions of the final helium shell flash and beg for an alternative explanation.