Fortunately the smart folks making Steam guides have it all figured out. But it's pretty shoddy at this point that standard settings like FOV, particular widescreen settings, stuttery framerate limits, and switching off their perennially ghastly mouse acceleration, are hidden in. It's certainly no shock that the UI is blatantly designed to be viewed from a sofa, so madly huge and clumsy for us with our noses pressed to the monitor.
It's no surprise that the in-game graphics options are negligible, requiring multiple quits and restarts to tweak to satisfaction. While we're certainly used to PC builds of their historically PC series coming out looking like they were sloughed off a console, hastily scraped off the floor, then dumped on a desktop, it still grates. Bethesda make big, divisive and generally extremely good games, but they really don't seem to know what a PC are.