Well, that was ugly.
Last year's crop of rookie quarterbacks set a high standard of excellence for Manuel, the only quarterback taken in the first round in the 2013 draft. He's not the instant success those guys turned out to be, but the Bills invested the 16th overall pick into their quarterback.
Manuel was cleared to return to practice Monday and was listed as a full participant all week on the Bills injury report. He didn't appear tentative running, either, with carries of eight and nine yards.
Some of his struggles could be attributed to rust, but make no mistake, Manuel had all the work he could have asked for.
He simply has to get better.
There were throws into coverage. There were missed throws of wide-open receivers. There were times where he threw too soon (a fade for wide receiver Stevie Johnson at the 1-yard line on third down), and there were times he was too late to pull the trigger (an out route to Johnson that was reeled in, but the receiver couldn't get both feet in bounds).
Some of his struggles were a result of bad decision-making; some of them were due to bad timing.
On this one, it was a little bit of both. Manuel was a little late on the throw, but he shouldn't have even delivered it in the first place. Cornerback Ike Taylor had safety help over the top and was able to undercut the out route by wide receiver T.J. Graham.
The Bills coaching staff probably didn't want to put too much of a burden on Manuel in his first game back from the knee injury, but they took the burden off him to the point of becoming too predictable. Their pass-run balance on first downs in the first half alone was 3-to-7. In the second half, that ratio tilted to 11-to-6 as they played catchup.
The Bills were horrible on third down, going 3-of-14, despite an average of 5.9 yards to go (league average headed into Week 10 was 7.21). They were able to keep the situations manageable but could not capitalize on them.
Failure to take advantage of big opportunities was a theme of the day for the Bills offense. The defense got off to a hot start by giving the Bills a start inside the Steelers' 50-yard line on their first two possessions, but the Bills were only able to turn those first two possessions into three points.
There have been some bright spots for Manuel, but usually not lasting over the course of a game.
He's completed less than 60 percent of his passes in his past four games. His low completion percentage has contributed in large part to the Bills woes on third downs.
So what can the Bills do differently to help Manuel?
There was also an interesting comment by CBS' Rich Gannon during the end of the broadcast. He mentioned that the Bills were in the shotgun too often, that they needed to put Manuel under center more often.
After going back through the game log, Manuel was under center on just 21 of the Bills' 64 offensive plays, and he lined up in the shotgun on 43 of those plays.
Patience in Manuel has just as much to do with his performance as it does with the coaches helping him develop into the best quarterback he can be.
It's not as though the Bills had no idea what they were getting themselves into when they drafted him. Presumably, he was heavily scouted. They knew that he was a quarterback with all the physical tools you could ask for, but who needed some polish on the fundamentals and the intricacies of the quarterback position.
They're learning those lessons firsthand as we speak.
His scouting report outlined those concerns before he was even drafted.
Sounds familiar, given his performance against the Steelers.
Manuel still has a long way to go in his development, but just six games into his NFL career, and coming off a knee injury, now is not the time to draw conclusions about what kind of quarterback Manuel will become.
Erik Frenz is also a Patriots/AFC East writer for Boston.com. Unless otherwise noted, all quotes were obtained firsthand or via team news releases.