By picking intelligent defaults, we hope that users never have to use the options screen. In the event that they do, we hope that we have so few options that managing and comprehending the whole set is easy. The options design was left until late in the process so that the team would have to live with the defaults.
The options dialog is divided into three usage-based tabs - the majority of users will only ever need the options in the Basics tab, a minority will need the items in the Minor Tweaks tab, and very few will ever need to examine Under the Hood. We had initially attempted content-based sections, but that lead to confusion over where a given preference should exist, and mixed useful and esoteric preferences together.
Over time, we hope to reduce the number of options further.