As a base try
NVIDIA: vsync = fast
Device settings in Oculus home: 80hz 1.2x
OTT: select 1080ti under link
MSFS: TAA 100, Objects 100, Terrain 100
Use Oculus OPENXPR runtime.
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Everything else medium or off
Try that, don’t have anything else set.
If you monitor FPS you should have a smooth flight at 40fps, slight judder as you drop below and as you rise above.
If this works then set about fixing FPS at 40.
If this kind of works drop TAA by 10 and see if that helps, don’t go below 60, as something else is wrong.
but if this does not work sorry I am not sure what else to try.