MAD still applies to Israel if they can field a sufficient submarine force to retaliate against a first-strike, unless their opposition can also field enough hunter-killer submarines to perform a full decapitation with surety.

Also worth pointing out, while a theocratic takeover of a state like Pakistan would be infinitely problematic, (probably) particularly for non-proliferation, MAD still applies unless the takeover is a flat-out doomsday cult. Problematic as I may find an Islamist theocracy as a Westerner, they're not insane, but simply of very different cultural belief. Should anyone want to live to see tomorrow, and or allow their offspring to do so then MAD applies.