I have a 2020 F350 and the B&W 20k version...
1st off, its a great hitch, and they are great to deal with if you have any questions.
The height adjustment will depend on your trailer... I ended up in the middle setting for my trailer, I believe that is 17-1/2".. They have 3 settings for height - 16-1/2" - 17-1/2" and 18-1/2".. that will be trial and error..
For the fore and aft settings. I have mine closest to the rear.. I would be too close to the trailer with the tailgate down for comfort with it all the way forward..
I think the weight distributed towards the front axle in minimal so I was not worried about it.

