I play medium as if iron Man is enabled--it isn't, but I generally only reload if something terrible happens due to a stupid mistake or I want to try/test something. Basically, I want to win, but I want there to be risk. I always play the whole way through the final mission. Sometimes I intend to continue on past that, but I never do. I don't enjoy the infestation event and played a couple of times with it forcibly disabled, but now I simply don't leave under-mountain areas cleared.

I have about a dozen mods installed, but nothing extravagant. Just a few for QoL and several inconsequential extras like additional hair styles and music.