
Occasional slowdowns, appear to be a game issue rather than a Proton issue since they happen on Windows as well
No major issues or performance dips that I imagine would be a dealbreaker for anyone. Small issue is the game is frame-timed, so if you like turning down the framerate to save battery like I do, that's just not an option. The game will slow down if you do this. I believe the same thing applies if you have a monitor above 60 FPS, but I can't test that. Either way if you're willing to put up with the admittedly annoying framerate quirks, this game is as good now as it was 20 years ago. I do recommend.

Only 2 major issues are the occasional out-of-sync audio in cutscenes and random control issue. Both can be taken care of for the most part.
From the Steam Deck quick-access menu:
- 30 FPS limit
- Half-rate shading kept on
Out of sync audio during cutscenes. Turned all graphics setting down to the lowest possible and afterward audio syncs most of the time. Possibly can't be completely eliminated.
Potentially game-breaking controller issue. Controller icons randomly change to keyboard controls and no controller input registers properly. Happened occasionally; 2-3 times during my roughly 28 hour playthrough so far. Only way I can fix this is to close the game completely and then restart it.
The game is mostly fine after the settings adjustment. Old game but very good once you get used to the controls. Can feel slightly grindy at times but still fun.
The game runs perfectly fine on the default settings the game gives. Despite Steam stating that non-Steam-Deck buttons would appear, I never saw any.

Plays perfectly. The launch option is only required if using the re4_tweaks mod (the mod won't load without it).
WINEDLLOVERRIDES="dinput8=n,b" %command%
If using the re4_tweaks mod, you will want to assign the F1 key somewhere to access the mod's configuration menu.
Using the alternate frame rate limiter option in re4_tweaks mod will reduce CPU usage
Using re4_tweaks mod with 16:10 support enabled causes pre-rendered videos to be cropped on the sides.
If using gamepad controls, the game applies a very large deadzone by default. Recommend setting the anti-deadzone sliders for each stick in Steam's control configurator to somewhere around 6000, depending on your preference.
Alternatively, use the re4_tweaks mod with its default deadzone settings.
When using the re4_ tweaks mod, the game seems to have periodic frame hiccups. When these happen during cutscenes, they cause the video to fall out-of-sync with the audio. Not sure which setting is responsible - possibly the frame rate limiter, Vulkan renderer, multi-threading support, disabled v-sync, or something else.
The re4_tweaks mod is not really neccesary unless you want to play at 60 FPS. At 60 without the mod, certain animations will play twice as fast as they should, and quick-time events will be significantly harder than intended.
The mod can provide several quality-of-life improvements even at 30 FPS though, like subtitles, FOV adjustment, and increased battery life, though it may come at the cost of occasional stuttering throughout the game.
DXVK_ASYNC=1 WINEDLLOVERRIDES="dinput8=n,b" %command%
I got consistent lag spikes when trying to run at 60 FPS. Limiting the frame rate to 59 FPS seems to fix everything.
Works excellent out the box. Installing/running HD Project is 100% possible but iffy to sustain (read below).
Vanilla is entirely playable front to back, both handling and looking great on Deck. Even re4 tweaks is easy to install and use (you should bind F1 to a backbutton or chorded press), and I'd recommend it for removing those stinky 16:10 black bars.
The popular HD Project, however, has a slightly more involved install process which is outlined here https://www.re4hd.com/?page_id=9654. Once that's done however it still runs excellently, albiet load times (including opening inventory or triggering cutscenes) takes a fraction of a second longer. One thing to look out for is Steam's auto-downloading of precached shaders, as this can conflict with HD Project. At one point it caused the game to break and slowdown to a crawl, which I fixed on a whim by switching to ProtonGE.
When booting in gaming mode, the game crashes and I get kicked back to the Steam meanu. When booting in desktop mode, a black screen takes up part of my screen then almost immediately crashes.
I've tried using re4_tweaks and the WINEDLLOVERRIDES="dinput8=n,b" %command% launch options, and that didn't work either. The game is current yellow for Steam Deck compatibility. I've tried launching with Proton Experimental, 7.0-2, and 6.3-8, but none have managed to launch the game.
I've attached a log of my issues. https://pastebin.com/nQux71Q8
Using a custom layout to use the trackpad and gyro to aim is great but it means that the prompts are keyboard keys, which isn't ideal but I quickly got used to it
The few saves I had near water effects did not demonstrate flickering as mentioned in other Proton reports. I had a save near the beginning, and in the Ada scenario, both worked really well.