RPG elements: no, they are completely removed and to be forgotten. The only thing that's kind of still there is dialogue choices, but those are definitely on the thin side. So thin that if it were ice and you were standing on it, it would break.
Weapons: I realize .223 and 5.56 are essentially the same, and I can totally understand removing one of them, but that doesn't make up for all of the other missing calibers and the missing guns that shoot them. It's a system with few base weapons and tons of mods. It's like Gran Turismo, where they include US and JDM versions of the car when the only difference is which side the steering wheel is on, and of course it counts as a different car so it adds to the massive 1000+ car count, when really there's less than 500 uniquely different cars. It's a form of deceit. I was lied to, and I hate being lied to.
Armor: My grief with armor is that it's equipped in pieces. That's my only grief. If there was a way to group armor by type/style so the pieces aren't scattered all over my inventory, I might be able to manage it. Or an option to equip all pieces of a certain type of armor at once without having to dig through the inventory to find them. It's complicated when it doesn't have to be.
Food/drink/beds: All I want is hardcoe mode returned. I don't care to eat food or drink when a stimpak does the same thing without the radiation. I gave my food/drink to my settlers because I see no reason to eat/drink when there's no hunger/thirst and a stimpak won't cure hunger or thirst in a hardcoe mode. Yes it increases your HP but who cares when not eating/drinking doesn't lower your health. Beds are the same way. If I wander the wasteland for days on end without sleeping/eating/drinking, it should have an effect, but it doesn't. Also, it's far too easy to avoid radiation when you don't have to eat or drink. You're in an irradiated wasteland, you have to eat irradiated food to survive, but not in FO4. Which also makes rad-x almost useless too. I can't count how many times I had to take rad-x because I had to eat lots of irradiated food to cure my hunger. Just one more facet of realism/role playing out the window.
Graphics: I'm running full AMD as well, and playing at 4k. The bad textures are super obvious at 4k. Not to mention the LOD's are bugged and the close textures take forever to load, which makes it even worse. The NV gameworks godrays absolutely kill performance and even more so on AMD systems, but add so much to the graphical feel of the environment. The system requirements are absurd. Although it runs better than expected for me, some people won't be so lucky. I get slowdowns in areas populated with lots of trees/grass/lights, but I'm not about to complain about that because that's normal in any game and always has been.
Sound: I should have categorized this as voices. The sounds themselves are good. I've heard better, (um BF:BC2 war tapes setting anyone?) but they're good. The main protag's voice is what I don't like. I actually don't want any voice but I definitely don't want his, and his acting isn't great either.
Response to your edit: I could criticize lots of other stuff too, but those are the main things.
The main iceberg that caused my response is like this: Fallout 4 is like finally coming home after being deployed at war for 5 years only to find your wife is married to another man. The RPG love of my life, Fallout, is no longer an RPG, it's a story driven shooter, which I don't care much for. It's married to a different genre.