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Screen resolution?
System Specs?
As for the quality settings... Try the low preset, with the FX option bumped up to medium (it runs better than low for most people, oddly), scaling option set to CAS, supersampling no higher than 1 (You might need to drop it to 0.75), antialiasing off... Won't be very pretty, should run well most of the time though (settlements with a few NPCs will probably be a bit sluggish).
Definitely try dropping the resolution, and or use FSR scaling.
I used to run a 1060 6GB at that resolution and it wasn't fun
You can still pick a resolution that matches your aspect ratio.
Or you can keep the same res, but use supersampling at 0.75x, or FSR 1.0
21:9 resolutions are: 2560×1080, 3440×1440, 3840×1600