been awhile since I looked at your config, have to say I like alot of the work you're doing but it's mildly infuriating to have to go through 4 text files just to figure out which shadow or lighting quality I'm using.
-edit-
Some other things
fps_max - Why is this set to 240, and not for instance 300?
r_norefresh 1 - what's this?
how do you feel about the new hud element that's being enforced by default
tf_use_match_hud I think
cl_mute_all_comms 1 - The wording in the github repository you have for commands is a bit ambiguous. As I understand it this means you have the ability to mute all comms from people at will, not necessarily all comms by default right?
for the texture settings why do you have mat_filtertextures in there twice with opposite values?
for mid-low which has the description of max performance but without bugs and good visibility, so why is
r_eyes 1 (in the characters_medium section) used
cl_particle_batch_mode 1 and 2 - what's the difference between these 2 settings
cl_smoothtime - you have this at 0.1 when you used to recommend cl_smoothtime 0.0455 what changed?
hud_escort_interp 0.1 - what is this?
snd_mixahead - you have this at 0.08 is this actually the best value for a reason or could it be set lower without issues such as 0.066
I don't understand alot of the sound commands so I'm just going to copy a paste the ones I'm primarily wondering about
snd_spatialize_roundrobin 1
dsp_room 0
dsp_facingaway 30
dsp_speaker 50
dsp_water 14
dsp_spatial 40
snd_defer_trace 1
snd_disable_mixer_duck 0
are their any differences beyond sound quality itself such as latency with different settings
-edit2-
recommended launch options for better FPS or less frame variance but without necessarily destroying the way the game looks