Requirements:
-All official DLCs
-New Equipment Overhaul
-Encounter Zone Recalculation
-Uncapped Level Scaling and Encounter Zones
-Unofficial Fallout 4 Patch
-Fallout 4 Fixes (and Consistency Tweaks)

Recommended mods and settings:
-Auto Lockpick
-Auto Hack
-True Storms (with max glowing sea and far harbor rad multipliers)
-Pain Train and Impact Landing - Buffed and Reworked
-Encumbrance Rebalance
-Power Armor Collections 76 Style
-Weightless Items (specifically zero out everything but weapons and armor, this gives the illusion of being able to access your junk from anywhere like 76 by simply being able to carry it all with you, and was also the settings this mod was balanced around)
-Darker Nights (darkest option, vanilla detection, no nightvision change. this allows melee sneak to be much more viable)
-Alternative Vision (max brightness, color doesn't matter, meant to go with Darker Nights)

Not recommended with any other mod that heavily rebalances the game.
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Welcome to Pseudo 76, my first real attempt at a major rebalance mod. This mod started out as a personal tweaks plugin, but I decided to evolve it into this fully-fledged rebalance mod. Inspired by Fallout 76, this mod aims to maintain a consistent level of challenge throughout the entire game, trying to stay as close to the vanilla game as possible, only making changes in key areas, with a sprinkle of my own personal preferences. While there are plenty of rebalance mods out there whose goal is to make the game more hardcore, I tried to go for a more vanilla-plus-style approach, with the late-game being prioritized over the early-game, but the early-game transitioning smoother into the late-game.
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Changes & design philosophy:

This mod is balanced around Normal difficulty, although there are appropriate damage multipliers for easier and harder difficulties. The player's damage multiplier never goes under 100%, however, as I feel this would throw off balance and not add much challenge.

This list is of most, if not all, of the major changes this mod makes, however I may have left out a few minor changes. There may also be a few of my own vanilla fixes in there, which should be relatively harmless. You may also recognize a few of my standalone mods that were integrated into this one. When that is the case, it should be safe to uninstall the standalone one in favor of the one integrated into this mod. It's probably also safe to just leave it be, but it might get messy. Do whatever suits you.

Weapons:

-Tesla Arcs and Flamethrower Traps are now destructible, and turrets and traps in general do much more damage
*(since they are stationary objects, I wanted turrets and traps to be deadlier so they are actually dangerous even late game and don't turn into something you can just ignore eventually)

-The Gatling Laser now has its own ammo type. at a chem workbench, you can convert 1 fusion core to 500 Gatling Laser Charge
*(to allow reloading prematurely without having half-empty fusion cores clutter your inventory)

-Explosives in general do more damage, ignore LoS checks, and large explosions heavily stagger
*(Explosives in vanilla more often than not fail the LoS check because of a small grain of sand on the ground, making explosives practically useless. these changes make them much more dangerous to both enemies and the player, especially late game)

-Melee weapons and weapon bashing do 5x more damage by default
*(melee combat as well as weapon bashing in vanilla isn't very threatening, with your lower health I wanted melee to be more rewarding given the risk, and I wanted weapon bashing to act as a more literal "quick melee", as in an attack that is as powerful as a melee attack that you can quickly use with any ranged weapon. most of the time the vanilla bash is insufficient at finishing off most low health enemies even when it looks like it should've)

-Several weapon damage values have been changed in accordance with level 45/50 fallout 76 weapon damage values
*(fallout 76 seems to have a better grasp on the amount of damage certain guns should do, such as shotguns and miniguns being more deadly up-close since they're incredibly inaccurate at range. while most of the changes are verbatim, I've made a couple tweaks here and there from playtesting)

-Pulse grenades do 10x extra damage to robots, synths, and power armor
*(I was surprised to learn that this wasn't a vanilla feature, considering that's the only reason pulse grenades should exist)

-The vertibird minigun is more accurate
*(to compensate for the extreme distance from your enemies, making it more likely you'll actually kill stuff with it)

-Energy weapon barrel mods no longer affect ammo capacity (with the exception of the plasma flamer barrel), instead the capacitor mods set the capacity between 30-60 rounds
*(I was always confused as to why both capacitors and barrels affected ammo capacity on energy weapons. you end up getting a lot of weird mag sizes like 39 or 28)

Armor:

*(Note: I wanted New Equipment Overhaul to take care of the non-power armor rebalancing. I consider it a good vanilla plus mod that gives you more control over your armor, clothing, and how you wear it, plus the player can have a lot more damage resistance than vanilla which I think works well in tandem with the lower health concept and acts similarly to fallout 76)

-Power Armor is 10x more durable
*(I found that while wearing power armor, I spent more time repairing it than I did wearing it, ultimately reducing its overall effectiveness to a point I didn't like. fallout 76's power armor is also FAR more durable in comparison, and I wanted to reflect that)

-Power Armor costs more materials to repair
*(The default repair values are balanced around your power armor breaking frequently. Since it no longer does that, I transferred over the repair materials as well)

-T-51 and T-60 have had their base stats swapped
*(This is a lore consistency fix that was integrated into fallout 76)

-Gas Masks give more radiation resistance
*(this is so gas masks have a meaningful purpose inside lightly irradiated zones that don't have enough radiation to warrant rad-x but too much to be without protection)

-Power Armor inherently grants a flat 50% damage reduction
*(I often felt that I was taking more damage in power armor than I was out of it, so this helps to lessen that feeling. this is also similar to how power armor works in fallout 76, with each power armor piece granting 7% damage reduction for a total of 42%, but I wanted to take a more straightforward approach to keep from having to modify every power armor piece. additionally, while fallout 4 seems to grant 5% damage reduction per power armor piece, it most likely stacks multiplicatively, resulting in much lower damage reduction than fallout 76, which stacks additively)

Player/Enemy:

-The player's base health is now 250, and no longer gains health per level, but still gains 5 health per point of endurance (for 50 extra health at max endurance)
*(a change taken directly from fallout 76, meant to keep the player from becoming a bullet-sponge themselves)

-NPCs gain a health increase 4x their current level (down from 5x in vanilla) but no longer gain an invisible multiplier based on their endurance (separate from the visible endurance bonus of 5 health per endurance)
*(this ends up cutting down significantly on bullet-sponges while also keeping enemies from dying in one shot, which is the other side of the spectrum that I also don't like)

-NPCs do 2x damage (the player's damage is unmodified)
*(By default, fallout 76 is set to Survival difficulty, meaning enemies do double damage and the player does half damage. I left the player's damage multiplier at 100% since in fallout 76, it's most likely kept reduced to half to compensate for playing with other people)

-certain high-level NPCs no longer gain invisible perk-based damage multipliers
(in testing, this resulted in the laser rifle doing insane amounts of damage to the player. as it turns out, there's not only unplayable perks that increase damage for NPCs, but reduce it as well. these multipliers are no longer needed as the weapons themselves are more powerful on top of enemies already doing 2x base damage)

-Vendors have way more caps
*(more on this below)

-The default carry weight is 500, with each point of strength granting +25 instead of +10
*(I wanted the player to be able to carry lots of loot and sell lots of loot, since it's an important component of the game that I feel is undermined in vanilla and with other mods that severely reduce carry weight. I also think bethesda didn't consider the fact that with the addition of the junk/component system, that you would need more carry weight to go along with it)

-Jump height is doubled
*(I wanted jumping to be more useful, allowing the player to reach higher ground at a moment's notice and allow traversal to be smoother)

-NPCs can no longer block
*(as it ultimately results in a tennis-style back-and-forth between the combatants that goes nowhere and makes melee combat very unrewarding)

-NPCs no longer weapon bash
*(this feature is ultimately more annoying than it is an actual attack, and on higher FOVs it can look like an enemy is hitting you from a mile away. enemies will opt to shoot you instead, similar to earlier entries)

-Vertibirds and their pilots have 2x health and 90% limb damage reduction
*(so they stop getting shot down by low-tier enemies)

-Player can no longer be grabbed or killmoved
*(I found this feature to be more annoying than anything, taking control away from the player so your enemy can get free hits or even kill you without allowing you any say in the matter is quite bad)

-Limbs no longer automatically regenerate nor are they healed with stimpaks, and instead must be healed with blood packs
*(the crippled limb system in vanilla has so much depth and animation detail that is undermined by the fact that your limbs magically heal themselves outside of combat. removing this feature gives greater purpose to resource management, beds, and doctors. blood packs are used to heal limbs as I felt they were already integrated into the loot system at a decent level of rarity given what they can do now, similar to doctor's bags in earlier entries)

-Oversized enemies such as deathclaws, yao guai, behemoths etc. have more health
*(in order to set them apart relative to lower-tier enemies so fighting them feels more like a boss fight)

-NPCs with fat mans are now given missile launchers instead
*(another change carried over from fallout 76, I assume bethesda finally came to their senses and stopped giving fat mans out like cheap cigars considering how powerful they are)

Perks:

-The perk Rad Resistant grants more meaningful radiation resistance
*(just so it's more useful and also because most armor does not inherently grant you radiation resistance in vanilla fallout 4, while it does in fallout 76)

-Inspirational grants your companion 60% more damage and 90% damage reduction
*(so they can keep up with the player and defend themselves better. I also wanted companions to be decent when you find them and for the player not be obligated to set them up with better gear themselves)

-Lone Wanderer works with companions and has been renamed to Experienced Wanderer
*(I wanted traveling with companions to be more of a personal choice and less of something you would intentionally include or leave out in a build. I also wanted to try and balance the late game around having all perks)

-The perks Toughness, Refractor, Rooted, Moving Target, Experienced Wanderer, and Nerd Rage now give damage reduction in addition to damage resistance
*(direct inspiration from fallout 76, late-game revolves around having a lot of damage reduction in addition to damage resistance to compensate for the player's low health compared to vanilla)

-Cannibal has been changed/buffed in accordance with player health changes as well as scaring humans & non-feral ghouls
*(vanilla cannibal ends up being kinda useless late-game with how much health the player has by that point. I also added a fear effect so it has a practical purpose on top of the health regen since most of the time a stimpak is better)

-Chem Resistant rank 2 has been removed
*(so chem addiction must still be dealt with late game, and to balance out the fact that chems are much more powerful)

-Adamantium Skeleton maxes out at 50% instead of 100%
*(so crippled limbs must still be dealt with late game)

-Lead Belly now uses percentage-based ingested radiation resistance instead of standard ingested radiation resistance and caps out at 50%
*(in vanilla, Lead Belly gives you 10 ingested radiation resistance at rank 1 and 20 at rank 2. I wanted the perk to act more like it does in previous entries, so now it's percentage-based instead)

Misc:

-Chem effects no longer stack (but their addiction effects still do), and food effects of the same type no longer stack but are more powerful on their own
*(this is to add greater purpose to combo chems like buffjet, psychotats, etc. food effects in vanilla needed to be stacked to be worth it but very rarely did I find myself keeping track of all the effects and stacking accordingly, so individual effects are more powerful instead)

-Leveling is approximately 4x faster
*(I wanted the player to be able to move on to more challenging content sooner and spend less time in the starting area around Sanctuary. I also wanted level ups to be more frequent at later levels and not bottom-out around 100)

-The player is alerted much earlier to their low health
*(because of how much lower it is now)

-Cap stashes give more caps
*(the vanilla reward didn't really feel worth it)

-Burnt comics/magazines as well as folders now count as junk and grant 1 cloth
*(they serve you better as junk to scrap than they do junk to sell)

-Cars no longer explode
*(so you can use them as cover. also I'm pretty sure the deathclaws ability to throw cars at you only works on cars that haven't exploded, so they should do that more often now as well)

-Automatron mods are no longer unstable
*(personal preference, I think the mechanic is dumb)

-Stimpak and Stealth Boy use animations have been removed
*(stealth boy animation was removed for consistency, but stimpak animation was removed to allow for spam healing to save yourself when an enemy does an unexpected amount of damage. this results in more stimpak usage and less dying, so you hopefully have, at the very least, a smaller stockpile of stimpaks compared to vanilla)

-Workbenches no longer require Local Leader 2
*(I wanted the player to be able to upgrade their equipment sooner and more often in order to keep up with how fast leveling is and how difficult enemies can get quickly)

and that's all the major changes I can think of. I wrote this list as I was developing the mod so it should be up-to-date and fairly comprehensive of all the changes.

Enjoy!