In the Patreon version your old family will be a befriended family (you knew them since your childhood, like a second family) and live with them. In the non-Patreon version, there is incest content.
Game options are...
NTR OFF:
NTR off is like vanilla sandbox mode. No one is fucking- only the NPC or lesbian sex when the MC sets it up. So you can play around without running into some NTR accidentally. Exception: Girls who have boyfriends before the MC shows his interest in the girl will have interactions in their relationships. But- no sex, maybe kissing or petting, but no intercourse.
NTR on / Hard-NTR OFF:
The "normal" game. You can get NTR'd when you lose too much relationship points with a girl. In this mode you will get challenged by other males to protect your "women". This mode will still be easy and you will get some warnings before you get near NTR content with any girls. You'll be able to boost relationship points with gifts or special events. NTR will mostly happen if you play into it. (Maybe if you want to get ntr'd and then conquer your woman back.) Or mix your game up. It's very obvious when NTR could happen , so it's not hard to find the right answers/actions.
Hard-NTR
Hard-NTR is like the normal NTR game, but you lose all the time and your choices are useless. This is for players who just want to see the NTR stuff and aren't interested in the normal game.