You're more likely to find duplicate items the more diverse your inventory is (To keep it near but slightly more varied when compared to vanilla).

Vanilla:

Modded:

ESBM:

Beetles now jump at you when attacking (similar to inferno).

All characters' (survivors, enemies, etc.) stats are configurable in a config file on launch (Make sure to set what you want to change to True, and then on another launch, it will generate detailed stats for it).

Every player will respawn for certain things.

• Before every final boss
• After the teleporter event
• After void fields

Enemies will build up tolerance to stuns and freezes each time they are hit, making the next stun/freeze slightly shorter.

Captain's diablo strike no longer hits allies (But he can still hit himself)

• Mithrix will not apply cripple on any of its attacks during P4. Because Umbral P4 is a bunch of dodging, and if you get hit once, you get crippled, then do not have the movement speed to be able to keep dodging, then you get hit and crippled more, and die.

• Mithrix no longer spawns glass clones

• Black Monolith from Mystic's Items is changed from green to red and adds 2 uses instead of 1

• Captains Favor from Hex3mod now corrupts sale star

• The Unforgivable from Hex3mod now stacks at -25% cooldown instead of 50%

• Razorhive from Razorhive no longer refreshes itself on hit