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The other approach would be to buff weapon damage, which would take a lot less time screwing with the creation kit but you'd have the problem of everything one-shotting everything at low levels.
That's why higher level enemies become bullet sponges. Surprisingly, weapons with bleed effect will murder higher level enemies with ease since they don't have resistance to bleed effect.
-acid soaker patch fix mod that makes it actually worth giving a ♥♥♥♥ about
-survival mode in vanilla game makes it so that enemies can easily kill you
-if you do you may wanna install the enable pipboy fast travel and the no instakill animation mods unless you wanna be extremely sneak
-you can ♥♥♥♥ around with the game files or console command to tweak the damage of weapons or mod your own
-in terms of weapons i think there are some like the m1 garand mod that lets you choose how much damage you wanna deal (abiet 1/2 1X 1.5X or 2X damage but it's still something).
-plasma caster mod (p-113) adds powerful plasma casters that can one shot kill most enemies but hard to get craft or maintain via ammo production
-you can lower your health to like 1 via console commands if you wanna have the 1 health challenge some youtubers do.
Keep in mind, in real life, most gun shot wounds are not fatal. And there are several cases of people being shot several times and still, not only survive, but can still be effective during the encounter.
Basically, it de-sponges targets that should NOT be sponging bullets realistically (humans, dogs, small animals, etc), while keeping larger targets very durable and hard to kill (deathclaws), and with some things in between (robots, synths especially are much harder to kill).
Also it has some modular components built in, such as headshot support. Basically, versus humans, any bullet that hits the had area will kill them instantly (player immune for gameplay reasons) UNLESS they have adequate head protection (metal helmet, power armor, etc, not a sack hood), then only higher calibur bullets will penetrate (such as .308 and .50). That's for humans though. A deathclaw is immune to headshots, as are robots. And some creatures like yaoi gui require 50 cal rounds to do it.
Just a warning though, it does obviously make early game quite difficult at times. Raiders with automatics or shotguns at close range are certain death without armor.
Also maybe Modern Firearms, depending what you mean by "realistic". (Personally I prefer the alternate-history future weapons of FO4).
Better Locational damage is indeed a great mod. Yet a small critic is that this one is not realistic. Why that choice. But ah well, they are supposed to be tough.