I have it highly configured - content is imported from DNDBeyond. Combat is mostly automated. The players choose a target and click their attack or spell, and Foundry automatically rolls the attack, compares against AC and auto-rolls and applies damage on a hit. AOE effects let the player place a template.
Handouts are neatly organized in the Journal tab and I also make playlists that auto play when I move us to a new scene (e.g. activating a random encounter scene starts my combat playlist on shuffle).
My players love it. With that said, I’m a software developer by profession, and all these things take a ton of work to get going and can be buggy at times.
Other non 5E games sometimes have great official support on Foundry, but for 5E you’re on your own.