Since so much of the original Wasteland/Fallout/Black Isle team was involved, a lot of that DNA shows through. I just made my first "multiple emergency calls are coming in, Ranger. Whatcha gonna do?" decision and felt that the decision had the appropriate heft to it, where some people are pleased and some are angry. My decision to assist the ag center left me with something that I think might be important later on, so I'm interested to see how that develops.
There's a lot of exploration on the map. Hidden locations exist, some you can just stumble upon but some you need to be told about. I stumbled upon an abandoned railway overrun with robots so I got the fuck out of there. Your ability to travel the map is limited by the amount of water you can carry (replenishable at wells in towns and also oasises on the map), and your movement is generally restricted by the large clouds of radiation that you need to find routes through.
Speech is broken up into three types of persuasion, which was something BIS wanted to do for Van Buren but didn't get to. Likewise, many things that would be one skill in Fallout (like lockpicking and safecracking, or all the types of guns that would be considered small guns) are split up. Part of this, though, is that the team you get (four Rangers you can create, plus people you can recruit. I think the limit is 6) needs to diversify their skills, so specialization is important.
The art design is fantastic, especially in the level design. It captures that same aethetic of the Fallout games, which again, is no surprise.
Basically it's really good so far but I'm only a few hours in, so I can't say more yet.