I tried many, many recommended settings, with incremental success. Then I came across this video. I followed every step and now mine runs butter smooth and looks as good as the MSFS advertising videos. The video has more than 3,000 likes and no dislikes, and 500 thank-you comments. So it seems that it’s working for a lot of people.
I have all mods active and 40/50 fps on ground 55/65 fps in air with PMDG 737.
I run MSFS on a 3060ti + AMD 5800X3D and triple monitor 3x 1920x1080.
So i don’t know what is wrong with your configuration.