I think the presets are a good “baseline” to find one that works for your system.
After that you can increase / decrease the quality on certain aspects as you see fit.
Not all affect CPU and not all affect GPU so it’s finding the right balance.
Example on Ultra with everything maxed out, my GPU sits at about 70% utilization so I can increase the render scaling to improve the quality which brings my GPU load up safely.
Another scenario is trees. Some may not care for tree quality since they aren’t much of a factor in the sim so turning the quality to low and increasing say the clouds which do matter to high or ultra is a good trade off.
It all comes down to user needs and their hardware limitations.