I first started playing Fallout 76 and presumed it wasn't going to be optimized well, and I'll be blunt, it's not. But that doesn't mean that you can't do some troubleshooting to have it run much cleaner, and they're deceptively easy, just not compiled in one document. I'm writing this guide for people like me that enjoy Fallout and don't feel like dying ingame to frequent hitching and freezes.

The easiest and most effective fix I've found that you'll likely doubt does anything, this fix drastically improved my friends and I's experience and almost entirely removed the stuttering and frequent hitching.

• From steam, select the Fallout 76 game in your Library, Right Click and select Properties
  
• Tab over to Local Files at the top of the window, and select Browse Local Files. This will open your file explorer to Fallout's files.
  
• Check the Run this program as administrator.

See image 1.

https://steamuserimages-a.akamaihd.net/ugc/1021698013227821997/4BAA910B8771D78F10882FB6504C0AF49A1E9D0D/?imw=256&&ima=fit&impolicy=Letterbox&imcolor=%23000000&letterbox=false

Whenever Fallout launches, if your monitor's refresh rate is set to high, it locks it hilariously low at 40fps no matter what system you're on. Don't worry, you don't have to have the framerate locked, and once you fix it, it doesn't seem to cause any glitches at all.
There are multiple ways to go about this. One way is lowering your refresh rate to 60hz in Radeon or Nvidia software, then raising it once you're in game. This isn't ideal and can be a hassle to get the game started, but it does work.
Another is this video by Kyle Davis on youtube, showing how to disable VSync and using Nvidia Profiler to have the framerate fine on startup.

This is similar to other bethesda games.

• Navigate to C:\Users\YourUsernameHere\Documents\My Games\Fallout 76
  
• Find the value "iPresentInterval" and change the value to 0 (1 by default is VSync enabled.)
  *Keep this file open for 4.

See image 2.

https://steamuserimages-a.akamaihd.net/ugc/1021698013227844584/B655719FF747A5E1A7A8A5D57EDBC57730D43116/?imw=256&&ima=fit&impolicy=Letterbox&imcolor=%23000000&letterbox=false

Everyone has their own tastes, so I understand leaving these on, but they will hit your performance.

• Follow the first 2 steps of the last instructions.
  
• Find the values "bDoDepthOfField" and "bMBEnable" and set both values to 0.

See image 3.

https://steamuserimages-a.akamaihd.net/ugc/1021698013227849334/3BCD3D804A747369D6F3CCAC1A948BDA896012D5/?imw=256&&ima=fit&impolicy=Letterbox&imcolor=%23000000&letterbox=false