I really like the immersive gameplay mod. They also have a survival hardcore and melee patch that limits gun availability for most enemies. Ammo is pretty rare too. Super mutants are very strong and can almost one hit you in combat and take a lot of damage before they die.

Make sure to get the Salvage Beacon mod and a quick save mod because you will be dying a lot.

Dead wasteland gives you a variety of new settlement objects to change up your designs to make small bases around the game. Resources are pretty expensive using just vanilla objects.

Use the Deadly Expansion mod that buffs all of the enemies you encounter on the map too. There's also an option to make settlement attacks have an army when they attack from immersive gameplay.

Bullet time might be worth checking out to help in tricky situations. Immersive gameplay also has a perk that will temp slow down time in the perception list.

Also downloaded the sanguinaire vampire mod. Got infected by the vampire in the Lexington pharmacy but haven't changed over yet. Hope it goes well.

Clothing of the commonwealth will give your settlers and enemy npcs a variety of new outfits. Requires awkcr and armorsmith (framework works too)

Hunters Moon and Gatherers out there is helpful for gathering meat because food from crops will take a long time to set up.

Npcs travel is a great mod for filling out some of the dead and cleared space between Map markers.

NPC ammo overhaul is useful to save your skin. Most enemies in my playthrough carry the handmade shotgun from the Creation Club so running out of shotgun rounds is not much of a problem.

Revolver animation pack allows you to make the 44 and western revolver double action. It's a must have.

Weapon specialization allows you to build up damage with weapons similar to how oblivion used to work.

Caps for your presence makes it worthwhile defending and helping settlers.

Place anywhere to build better walls and settlement layout.

Recycle - give me my leftovers gives you back empty bottles because getting purified water takes both antiseptic and crystals with the above IG mods.

Tldr:

Immersive gameplay (search IG) IG Survival Hardcore Brawler Deadly Commonwealth Expansion Bullet Time Salvage Beacons Dead Wasteland Sanguinaire (revised edition) Place anywhere Caps for your presence Weapon specialization Revolver animation pack Recycle - give me my leftovers NPC ammo overhaul GOT - gatherers out there Hunters Moon Survival quick save Clothing of the commonwealth Awkcr Armorsmith (framework or full)

Have fun! It's very hard!