Going through your list, food is based on buffs rather than starvation as described, hydration isn't simulated, temperature (and dryness) ranges from slight debuff to actively killing you, shelter and fire are based around a quite complex building system combining structural support, keeping the rain off and letting the smoke out, a room might register as sheltered on a good day but lose that status during a storm depending on wind direction.

Customising appearance, not so much. There's one set of armour for each difficulty tier and generally speaking everyone ready to head into region X or Y looks pretty much the same. There are a few different texture options for the various shields at least.