After playing for just a short while, the bindings for the Xbox controller change so that each button performs multiple actions. For instance, the "A" button will both use an item AND jump rather than just using an item. When I go into the settings, I can make the buttons all default, but the changes don't save and immediately revert back to the mixed up version of things.
This issue is a nuisance for the most part, but it's game breaking when it comes to selecting conversation dialogue as it's random as to which dialogue option is selected when choosing an option.
I ensured it wasn't the controller or otherwise my setup by testing the equipment in Skyrim, and it works fine there.