The controls are different. Now press Edit at the top left where it says Current Binding Vive Cosmos Controller Legacy Bindings.

Unfortunately, the resulting control scheme is nearly unplayable and in particular makes menus hard to navigate. By default, Fallout 4 VR treats Index controllers as Vive wands. You're now in a window that says Legacy Bindings (Handed). Copy it into your "Steam\steamapps\common\Fallout 4 VR" folder where you have F4VR installed (always backup your old one just in case) and use my bindings in Steam VR Dashboard controller settings they work perfectly with the game it maps every function in game. I figured the drivers/installation would patch my PC or something to translate my old Vive Pro controls into Cosmos (should have known better). Steam VR - Upper left corner with the 3 lines. Choose Skyrim VR as your application. Click it - select Devices - Controller settings. Top right select current controller Vive cosmos. I just purchased a Vive Cosmos assuming my VR games on Steam would work with the thing.