danilo29oliveira There are a few details here that I think are making this seem different or more complicated than it actually is. One is that the refresh rate of your monitor doesn't matter here. The monitor has no bearing on what the graphics card is doing—the GPU renders the frames and sends them on to be displayed however the screen is set to do so. Changing the monitor's refresh rate only changes what vertical sync means to the GPU.
The reason I mentioned the Adaptive v-sync setting is because it works in a different way. On means the GPU tries to match the refresh rate of the monitor, and if it can't, it drops down to the next-highest factor of that number. So at 144 Hz, the GPU would aim for 144, then 72 if 144 isn't possible, then 48, and so on. Adaptive means v-sync only applies over the monitor's refresh rate. So it caps framerates at 144, in this case, but has no effect on the fps below that. You could imagine how using On would make fps bounce all over the place in certain circumstances when the framerates are already dropping a bit.
The idea that the game is not optimized for 144 Hz screens (or similar) isn't really a valid concept in the way that it used to be. In older games, animations and the game clock could be tied to fps, giving weird effects at higher framerates. With new games, devs can have an fps target and adjust settings to try to hit it, but this mostly happens on consoles where the hardware is set. The optimizations for PC these days are more about balancing quality and performance but not typically about a specific framerate target.
Sims 4 clearly has issues with large lots and large numbers of sims on them, sometimes at lower thresholds than seems reasonable. One cause we've identified is that switching to a different LOD for an object or sim is enough work for the game engine that doing so for many objects at once can be a significant drag on performance. Increasing the maximum distance where the highest LOD can still be used means less switching and can therefore improve performance. Please see this thread if you want more information:
Camera movements very choppy since BH patch | EA Forums - 12185589
What doesn't help, necessarily, is lowering the graphics settings. Some delays appear to come from the game engine doing tasks behind the scenes, not from graphics rendering. So making graphics rendering easier doesn't touch the underlying issue. Simulation-related issues do appear to be on the devs' radar, but I don't have any details about that.
What I would suggest, however, is testing a new save with fresh sims and a default lot that are NOT from the Gallery or your own library. Many older creations are broken now, and even some newer ones don't work the way they should. The only way to be sure that this is entirely a game issue is to remove any complicating factors like a potentially broken sim or lot.