This is an RPG game disguised as a shooter. As such, it contains item synergies that allow to take multiple headshots with barely a scratch, which is in no way reasonable for an FPS.
The balance mechanic that answers some of these synergies, the great equalizer, is VATS. It creates a division between competition-oriented players, as for some, the main differentiation of effectiveness should be the aiming efficiency which plays a significant role in PvP, but is not the single solution to majority of the problems, as it is in majority of other, similarly looking games from the FPS genre.
But this game is not just an FPS, because FPSes don't have game engines where their weapon effects are classified as Enchantments and stored under Magic.
Reducing the importance of aiming in the mix of skills needed to succeed puts higher emphasis on other aspects of competitive gameplay, effectively turning the game into some form of FPS-skinned Tower Defence, where you reposition your character for maximised access to your opponent while minimising their access to you. Reading the toolset of your opponent, and applying appropriate tool combination for appropriate situation. I can't agree with the notion that such competition becomes skillless, and as a veteran FPS player, while writing content for the release of this website, as a break from testing F76 I return to my other favorite game series, which is Titanfall, an extremely quick and demanding FPS game. After a year spent fighting in F76, I see that my ability to aim remains very strong and my ability to outmaneuver and outplay the opponents have vastly improved when compared to before I dropped TF2 in favour of F76.
It's also false that you can simply shred any opponent without aiming when playing a non-stealthboyed fight, because whoever tried adjusting to the F76 combat environment is, by now, defaulty in sneak or in distance above 50 meters, which is the maximum VATS distance. VATSing a sneaking opponent requires manually hitting them first, which enables them to be VATSed as long as they're not invisible. If they're invisible from chameleon armor/mutation, you need to first hit them hard enough for stagger to kick them off their feet, manually. Smart people move in a way that makes VATSing them hard, and often use terrerain as protection.
Think of VATS as of spell-casting that has to be channelled for maximum effectiveness, and that's able to reduce the opponents defensive effects if you manage to apply these spells, because that is the function it serves when good fighters fight each other.
As I mentioned, VATS causes divisions. It steers some people completely away from F76 PvP, mostly because they don't understand how it works. It's also considered something 'inferior' by some people relying on aid-based builds. The same people quite often would be unable to support their playstyle without access to duplicated aid items, and joyfully present how proper 'skill' based aiming gameplay looks with their Tesla rifles or legacy lasers that require no precision. As such, there are two schools of PvP - the one that works better on Adventure, and the one that worked better on Survival. This website is written from the latter perspective, Survival mode focused, where dropping the aid as part of dying prevented infinite-aid playstyles from being maintainable even for those who could offload duped aid. This school also puts a huge "XD" on the notion that consuming hundreds of nuka quantums per fight is something that puts the people doing that in position to ridicule anything.