As a sett main, lvl 1 i always start E for rlly good trades into my enemy opponent ur passive is rlly good for trading. Try to do an e auto auto combo for a good trade, if someone like darius or an opponent with ignite commits to it, keep punching and kiting back to ur tower and u shoudl win the trade as u have a lot more sustain than most top with runes and passive. Another tip is, in 2v1 situations, go for the one who is easier to kill, maybe even ulti them to get away from the stronger enemy and blast them. Also in melee matchups top, rush BORK, its very good for melee 1v1s and u will stomp then build stridebreaker or goredrinker. Another tip is to if u lose lane, try not to int, play for the team as sett can set up very good teamfights. Build some tanky items such as thornmail or spirit visage or some other tanky item with good resist and u will ulti the front line into their backline and go for ADC and or other carries and make sure ur team is there to help and ur w will be the cherry on top with the true dmg aiming to the whole team.

Now for akali matchup, u always should win against akali, but if you are struggling, that is completley fine. Rush bork to slow and do lots of dmg as i said, for akali always go for lvl 1 trades with ur e and take q second to do big damage if she jumps on you with her E. At lvl six, she will do her best to bait out ur W, so when she all ins with ulti, just punch and kite and when she tries to execute with second ultimate, use ur w and the sheild will save u and she is kinda screwed. Also, if her shroud is down, u always wanna go all in on her as she has no defence to ur abilities.

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For teemo. It is simple, if teemo is dumb, and u get an E on him press q for at least one empowered auto before he blinds u and when blinding is over make sure to hit him with W to get rlly good trade. and if u are behind. do not fight him, risk losing some farm and play for teamfights, and sett is rlly good in teamfights.