Here are my system specs:

MoBo: MSI P67A-GD65 (B3)
>Intel P67 Northbridge
CPU: Intel Core i5-2500K @ 3.3GHz
>Quad Core
Memory: 8Gb DDR3 @ 1333MHz (2X 4Gb)
>Dual Channel
GPU: XFX nVidia GeForce 8800GT
>512Mb GDDR3 VRAM
>DirectX 10
PSU: 700Watt
Audio: Creative SB X-Fi Titanium
>ALchemy enabled
OS: Windows 7 Home Premium
>64bit
Hard Drive 1: Seagate Baracudda 7200 SATA
>500Gb
>7200 RPM
Hard Drive 2: Seagate Baracudda 7200 SATA
>500Gb
>7200 RPM

With that rig, the launcher pre-set me to Low quality. However, I am currently playing with all draw distances maxed and everything else (except shadows, which are rendered by the CPU) at max quality (Shadows are at High, down one step from Ultra).

40-60 FPS across the board. Shadow-heavy interiors, looking across Whiterun, staring across the world... nothing dents it.

That is with a GPU from 2008.

So really, the pre-set the launcher provides for your hardware setup is not worth a penny. You will have far better success manually tweaking the graphics options to suit your hardware.

And please, I am not trying to brag about performance, so don't go there.

Automatic settings in game menus are never, reliable. In any game. This is not surprising.