I’ve been using PCSX2 for a while now - since version 1.2.1 (2014).
There are a significant number of one-off fixes that are often necessary in games, from special hacks, to fixes like running all FMVs in software mode, to things like skipdraw for disabling buggy post-processing effects and TC offsets to fix sprite alignment issues - all kinds of things that are needed to offset various visual bugs brought on by upscaling. It’s just the nature of the thing. Some cases are nigh on perfect and others are a broken mess with any setting (even software, in a few cases). In some cases, it’ll never be perfect, regardless of settings used but with some adjustments you can get it “pretty close”. This is often a slow, tedious, and incredibly time-consuming process of testing, making changes, reading wiki and forum posts, testing, making more changes, and then testing some more.
There’s really no one-size-fits-all setting solution when it comes to PCSX2 configuration (other than setting it to software mode and leaving it there, and even then you’ll still run into some issues, just much less frequently) which means that you really need to create configurations on a per-game basis to get the most out of it. If you’ve tried your hand at PS2 emulation with PCSX2 for any length of time, you’ll know that it’s an impressive but thoroughly imperfect emulator that needs a guiding hand more than most.