I already own the game and all DLC.
What I want:
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A port to the Starfield engine.
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Higher-res textures. I have a present-day video card, and Fallout 4 has been out for ages.
From a very brief skim, it doesn't sound like either is present.
If one owns the full game already, it sounda like one gets a bunch of Creation Club stuff. This appears to be mostly some new items and skins. A "Sea Scavengers" quest and "Clandestine Couture" quest, which apparently come wirh new companions. There's a list at the link below.
Bethesda has, in the past, released updates (like texture resolution updates), and those might be only going into the Anniversary Edition moving forward, if it works like Skyrim did.
It sounds like they do include ultrawide monitor fixes and improvements, so for someone with that, that might be significant, but that may also be going to non-AE users. Might be worth investigating if you have an ultrawide monitor.
Setting aside the value issue, I'd hold off for a bit if you have a heavily modded install to see what consensus is on any breakage and to let modders fix things.
https://bethesda.net/en/article/3IN7gxAs893fv09b7ZJ3I0/fallout-4-anniversary-edition-now-available
If you own the standard edition of Fallout 4, you can pick up the Anniversary Edition Upgrade to receive the 6 expansions and the 150+ pieces of Creation Club content.
If you own the Fallout 4: Game of the Year Edition and just want to get the Creation Club content, you can get the Creations Bundle separately. Browse all the available content (including the individual items in the Creations Bundle) through the new in-game Creations menu.
It sounds like they're going to be putting out some other Creation Club quest content, but they don't say that that's gated on getting AE, and it doesn't sound like it's included with the upgrade:
Many new Creations are coming to Fallout 4, including “Tale of the Beast Hunter” from the team at Hobgoblin Studios which is available now! Pick it up through the Creations menu and uncover the legend of the Beast Hunter. Unlock the Beast Hunter’s outfit and his revolving shotgun and face off against his pet Deathclaw, Bessy, in a brutal showdown. “Tale of the Beast Hunter” is also your chance to bring a piece of the Mojave to the Commonwealth with ‘The Bar,’ a unique new player home that feels straight out of the Strip.