Settings

Open the wheel (B) and click Settings... in the bottom left.

Every option also has a tooltip in game, hover it.

Sound

My Emote Sounds - whether your emotes play their sound, for you and for players near you
Other Players' Emote Sounds - whether you hear the sounds of other players' emotes

Other Players

Other Players' Emotes - whether you see other players' emotes at all. When off, nobody can play emotes on your screen
Partner Emote Requests - whether others can ask you to join their partner emotes. You can still join one yourself

Looks

Emote Previews - 3D previews of each emote in the wheel and lists, or only names
Third Person While Emoting - goes to third person when you start an emote, and back when it ends
Elbows and Knees - how emotes that bend the arms and legs look

Elbows and Knees has 4 options:

Option	What it looks like
As Made	the way the emote was made (default)
Smooth	one limb that bends in the middle
Split	two halves turning into each other, like in Blockbench
Off	straight arms and legs, the classic look

Most of my emotes don't bend at all, so this mostly matters for emote packs. If another mod makes your limbs look weird while emoting, set it to Off.

Controls

Hold to Open Wheel - the wheel stays open while you hold the key, let go over an emote to play it

Packs

Packs... next to Settings lets you hide or show whole emote packs. Hidden packs don't show in the wheel or the lists.