When the VSync option is disabled, the Max FPS option will be populated with appropriate sync intervals that has the frame rate land between 30 and 60 FPS.When the VSync option is enabled, the game will dynamically engage and disengage the appropriate sync interval to keep the game locked to as close to 60 FPS as possible.What these settings control is the sync interval of V-Sync - on which nth refresh that a new frame from the game should be presented. Regardless of settings, V-Sync will always be used. The game does not feature an discrete FPS limiter but simulates one through the use of V-Sync and refreshing on the nth vertical blank of the display.
See the glossary page for potential alternatives.