To me the screenshots look like an issue with hinting, especially horizontally. Some vertical lines just end up too small. But I actually can't reproduce this here. Can you maybe show me how this needs to be configured on Windows 10? I find a setting to disable clear type, but afterwards it just guides you through a visual setup which seems to adjust general settings for anti-aliasing. I see no setting to explicitly turn on / off anti-aliasing in general.
Just turning off cleartype gives no difference for me compared to Picard 2.4.4 (which uses Qt 5.14.2, while current Picard for Windows uses 5.15.1).
Ultimately this is a Qt bug. I assume it was also you who opened the bug report for Qt at https://bugreports.qt.io/browse/QTBUG-88225 ?
We could try to just set always setHintingPreference(QFont::PreferVerticalHinting). AFAIK that's also what newer Freetype does by default, it ignores horizontal hinting. But actually I think there is no way to set a global default hinting preference in Qt, you have to do that per font. And that's something I really want to avoid. So this likely is a wontfix on our side and needs to be addressed by Qt.
Let's retest this after the Qt6 update