I reported this issue with 3080 and 3950X + 64GB RAM and SSD + various SWAP-files tested in the closed beta. Too bad it’s not fixed even now. 
Weirdly, it’s not related to the GPU either. I’ve the same stutter issue with the current AMD 7900 XTX. It’s a 24GB VRAM card, so definitely not about running out of VRAM.
I’ve silky smooth FPS, but when moving around the stutter is pesting me constantly. No other games suffer from this.
I’m on 4k monitor. I remember from CB that lowering the resolution from 4k to 1440p somewhat helped with the stutter, but it did not solve it completely. Yet again, 3080 ran the game very smooth back in CB too.
Here’s a list of various tests I’ve attempted:
- Latest chipset / GPU-drivers
- Disabled antivirus; including Windows security
- Increasing Diablo4.exe CPU prioritizing from normal to above normal
- Lowering textures to medium / shadows to medium
- Using temporal reconstruction
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Issue was present in CB as well. Sad to see the stuttering is still pesting 24-7.
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For now, the most likely reason is VRAM usage I believe. I’ve seen many other posts in reddit, the game will also use ~22GB VRAM on a 24GB card. No matter high or medium texture quality, they both use all of my 3080Ti 12GB VRAM. I believe there is VRAM memory leak this beta.
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Just wanted to throw my hat in the ring. Game runs terribly…borderline unplayable.
Have tried dozens of setting configurations.
I noticed it got much worse after entering Kyovashad, which (correct me if I’m wrong, Ive purposely not read much on the game) is also the first time the game introduces other players characters into your instance of the World. For what its worth I can play Battlefield 2042 at near max settings with this setup. (Don’t judge me) It’s a bit outdated but has been holding up fine.
Specs below
i7-6700 3.4ghz
Nvidia 2080 RTX Founders
32g RAM
Dual 27 inch curved displays
Edit: Wanted to add that stuttering even occurs when clicking on vendors to transact or clicking between items to sell/salvage. Very frustrating.
Tested and confirmed. The stuttering is about VRAM not being handled well by the game. So essentially - “optimization”.
The game uses currently 23GB out of 24GB VRAM on 7900 XTX (4k, maxed settings).
By lowering shadows and textures to medium, the VRAM usage dropped from 23GB to 14GB (I was in a dungeon). After walking out from the dungeon, I got a major stutter and noticed as the VRAM usage bumped up by 400MB in an instant.
= the stuttering is caused by poor VRAM handling, please report this forward @Zuvykree
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Chipping in my two cents: Can Confirm Same.
I have a Ryzen 5900x, 64 GB Ram, 3090 Founders Ed. w/ 24 GB ram, running a single windowed screen on Win10Pro (non-widescreen). Updated drivers, etc. Should be able to handle anything thrown at it. And we shouldn’t have to ‘dumb settings down’ to make the game playable. 
Lags as previously mentioned above.
Just found this post, but will look at Vram usage and see if i’m seeing the same items.
I have a 4080 rtx.
16ggb. it’s using 80% of my GPU;
and pretty much 100% of my dedicated GPU Memory (16gb)
i’m losing a lot of frames too
So I saw this on another post, but I had bad stuttering in town and in dungeons. I uninstalled the high res pack and voila no more stuttering. I think there is something janky going on with that high res pack. All it really did was change the option in game for textures so that high setting isn’t an option but only that particular setting. Everything else can be set to high and your game resolution can remain whatever it was previously as well as the frame rate. I literally just did it but I ran around for a few minutes and it is super smooth now.
If anyone is wondering, you got to the battle.net app and click the options wheel next to D4 Beta. Then click game settings, then modify install, then modify installation again and you will see a box ticked for high res package. If you uncheck and run the update it uninstalls about 45Gb of data.
For some, like me, it stutters with low rez textures, even with a 24GB GPU
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The VRAM keeps filling up eventually. It’s not properly handled by the game. If you change textures manually (from whatever option to another, eg. low to medium or high to medium) - it clears them.
→ when you start to stutter, do this.
nope doesn’t work as stated by many
Fex and fever, your fixes don’t apply to the constant studdering issues a lot of us have seen, unfortunately.
I’m hoping Blizzard can fix the issue before the open beta next weekend.
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The character selection screen is my new fidget spinner at this point, when the stutter hits while spinning a character with the mouse they will spazz out completely! 
I have the same issue. Geforce RTS 3080 and an AMD Ryzen 5800X3D.
Stutters mostly when in town, leaving a town portal, or using waypoints.
I9-9900k - rtx 4080. Game is stuttering really bad about every 20-40 seconds. Appears to happen mostly when loading new textures. Frames will be 140-150s then drop about 30-50 frames suddenly. Vsync has no effect on it whatsoever. 240 hz monitor. Hope this gets fixed before launch because it’s a game breaker for me honestly.
The issue is VRAM handling. I am saying there’s NO fix.
With higher VRAM cards, using lower textures and shadows might help for a while.
This is because changing the area changes the textures needed. It’s a VRAM issue.
I posted above on this thread with unplayable stuttering issues.
After messing around for a while I’ve found that if I can make it to a dungeon - the frame rate suddenly becomes stable for the entire dungeon - AND THEN, oddly, the game runs fairly stable after leaving the dungeon for a while. Strange, but at the very least I’ve been able to enjoy the game.
That is because you’ve managed to get the textures of the map loaded to the VRAM as it loads - unlike the world.