Depends on the game. Is it a game where I’m there for the scenery? Crank it all up. I want to see the world they created.

Is it a competitive game? I change everything for best balance of FPS and opponent visibility without making it too ugly. Motion blur, camera shake, film grain, music, cam animations like a roll after jumping from a height, all that unneeded stuff is immediately gone. I spend a couple days digging through recommended configs online to find the right changes that suit me.