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(+1)

Not to dismiss the author's skill set, but I'm pretty certain they use a popular model building engine. I've played several games which I believe have very similar models. not sure how much power or customization is involved with it though. It might literally just be sliders or it may be you manually move vertices in something like blender

(+4)(-2)

Usually, they are sliders.

I use custom objects created in Blender, custom clothes, custom textures, and even custom expressions, at least on new versions.
In the prologue (v0.1.2 and before), everything was quite simple as just sliders.