I tend to waver somewhat, depending on mood, how much I can be bothered, and the tweakability of the engine. I like to push the bounds of what you can create in there, particularly to make something that might otherwise be unusual... like a really short, squat, but surprisingly agile wrestler in WWF, mucking around in ... man, I can't even remember the actual name, but it was some kind of console based MMO... to make a surprisingly attractive female orc (I don't think it was actually supposed to be possible) who bore more than a passing resemblance in all but skin/hair colour to a particular character from a webcomic I was reading at the time (bonus points for guessing, ultranerds), or properly futzing with Second Life to create the most (realistically) masculine possible female and most (realistically) feminine possible male avis - without resorting to add-on meshes or skins - and seeing if they "passed".
And of course the old classic of trying to make one that looked as close as possible to my true self, which at least with SL proved rather uncanny (sorta like what an android version of myself would appear). Hence binning it and going for the aforementioned mucking-around, because... brrr.
If more bored or the engine just isn't up to snuff, I'll happily take whatever default or random-roll comes out. Or make the most deliberately dull and anodyne looking one. As you can tell from my forum avatar here, most of the time I just can't be bothered with that variety of expression (I'd remove the gender setting from it as well, if the board allowed it*) - not to mention it's actually pretty difficult to choose a single one that's in any way meaningful or representative - and just leave it blank, letting the words / actions do the talking instead.
As for the attributes ... well, again, attempt to defy expectations if possible (which can be a way of artificially ramping up the difficulty level, too). A warrior model with as many points in white magic and as few in melee attack as possible, for example. If I ever re-borrow my bro's PS2 off him, I've a game of FFX waiting to be finished where I'm basically doing just that with the Sphere Grid for each character. Trying my damnedest to make Yuna into a melee-weapon-using brawler and Tidus into a black mage, for example... Otherwise, I have no real set plan, just take the defaults or random rolls and try to level as best I can from there. There's usually too much random chance involved for anything other than a really extreme engine-fuck to hold any interest for me.
(* the handle is specifically "neuter", or at least I thought it would be (turns out it's a girl's name in Egypt, but I'd been using it for the better part of 15 years before I found out - hopefully it's not common knowledge anywhere else, either), as I find it amusing to watch people make up their own conclusions and then scrabble for pronouns when they have to. All the same, I've only two or three times been "properly" confused for female (ie someone expressing surprise at the reveal), so I guess even my mostly-anonymous online gender expression comes across as mainly "cis"... I've no qualms about embracing my feminine side, but presumably that's only comfortable for my subconscious a relatively small amount of the time... I suppose the test would be to actually RP a professedly female character in an RPG and see how long it takes for me to get called out as an Internet Transvestite.)