On about:config to the right of the search bar at the top is a checkbox "Show only modified preferences".
The notes idea would be interesting though ideally the names of the key and values would be descriptive enough the reasoning for the change is obvious in 95%+ of cases (the other 5% being noting a bug workaround). As is the key names are usually pretty good but some of the opaque enum values could definitely use a note (or text based values instead) e.g. things like TRR mode being set to 2 vs 3 is always a google search.
What are you looking for which the “show only modified preferences” button doesn't provide?
In this profile I have 230 modified preferences. I'm pretty sure scanning the list in "show only modified" that it is all of those. The vast majority were autoset by Firefox or Firefox extensions.
What I would love to find is prefs that I explicitly set manually in about:config. Those are the ones I realllly wanna find later if I messed something up. It would also be nice to have those explicitly set by a user action in Settings too.. Elsewhere contravariant mentioned "user.js" I'll look into that and it'll be super helpful on the desktop. Less so on Android where, thankfully, about:config is still accessible in the F-Droid Fennec firefox build (unfortunately they can't do anything about all my useful addons that were removed or removal of prior functionality but I'll take what I can get).
Things handful of things I the user have actually set to be a certain value not the hundreds of things that are not the initial value the instant you launch the browser for the first time or the hundreds more that change from normal use after that. Just the 3 or 4 I have actually changed.