Older ISA Sound Blaster cards indeed have jumpers to configure I/O ports, IRQ lines, and DMA addresses for the hardware, and traditionally there was no reliable way to auto-detect conflicts with other hardware — such conflicts are a likely source of your distorted audio — so manual reconfiguration was frequently required.
Additionally, Sound Blaster-compatible software requires either manual or semi-automatic configuration via the BLASTER environment variable or application-specific configuration mechanisms to determine the hardware configuration.
Creative indeed repurposed a couple infrequently-used pins on its implementation of the IBM PC game port[1] to implement a MIDI interface; other vendors followed suit.
In addition to computer music applications, external MIDI modules — most notably, the Roland MT-32[2] and Sound Canvas SC-55[3] — were commonly supported by games of the era[4].
Today, all this can be easily emulated in both software[5] and first-party emulated hardware[6]. Additionally, Sound Canvas was the basis for the General MIDI standard, so it's also possible to wire up DOSBox MIDI to other GM-compliant synths for similar results (at least in [relatively] newer games with General MIDI support; attempting to emulate MT-32 via GM rarely works out well).
Source: personal experience, though "back in the day" I used a Roland SCC-1, which combined an SC-55-compatible synth and an MPU-401-compatible[7] MIDI interface on an ISA card. For most games, this configuration also required a separate sound card for non-music sound effects, but was otherwise convenient, slots permitting, as it required no external hardware.
[1] https://en.wikipedia.org/wiki/Game_port
[2] https://en.wikipedia.org/wiki/Roland_MT-32
[3] https://en.wikipedia.org/wiki/Roland_SC-55
[4] https://en.wikipedia.org/wiki/List_of_MT-32-compatible_compu...
[5] https://dosbox-x.com/wiki/Guide%3ASetting-up-MIDI-in-DOSBox%...
[6] https://id.roland.com/products/sound_canvas_for_ios/
[7] https://en.wikipedia.org/wiki/MPU-401