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Exit the game and launcher.
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Go to “Documents”
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Under here, look for “Diablo IV”
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In here, rename the file called “LocalPrefs.txt” (or just “LocalPrefs”, if you aren’t showing file extensions) Just add a “.old” to the end.
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Then, restart the launcher, then restart the game. This should reset the game to defaults.
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You will then go through initial setup. (configuring brightness, etc)
You will not lose any progress or characters.
If for some reason that fails to fix the issue, then you need to do the following:
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Open the Nvidia control panel.
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Click on “Manage 3D settings”.
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Click the “Restore” button with the Nvidia logo on it.
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Then save settings and exit the Nvidia control panel.
Then try to play again.
Depending on how you originally had your system setup, you may need to reset some values back to what you might have customized them to.
For example, I would recommend capping the FPS no higher than your monitor refresh rate. Turning off Nvidia Reflex, DLSS, and Peripheral Lighting (Chroma Effects).