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1 year ago(Ryzen 7 1700, RX5700XT, 32gb ram) How much ram do you have? Previously i was running the game on max with 16gb of ram and it was an absolute stutter fest. Noticed it was eating shitloads of ram and i was running out. Only way to fix was to close firefox and run the game on medium.
I have since acquired an additional 16gb to total 32gb of ram and i can play the game flawlessly at 100fps @ 1080p max settings even with firefox in the background. I hit about 22/32gb utilization when playing D4 on max with all my other background programs running.
You could just need more ram!
I have a RX5700XT for this exact purpose but at 144hz and it still fits the bill. It should be more than good.