Microsoft adds Variable Refresh Rate For Games that lack Support
With Windows Version 1903, Microsoft have added a new toggle in Graphics Settings for variable refresh rate. Variable refresh rate (VRR) is similar to NVIDIA’s G-SYNC and VESA DisplayPort Adaptive-Sync.
This new OS support is only to augment these experiences and does not replace them. You should continue to use G-SYNC / Adaptive-Sync normally. This toggle doesn’t override any of the settings you’ve already configured in the G-SYNC or Adaptive-Sync control panels. This new toggle enables VRR support for DX11 full-screen games that did not support VRR natively, so these games can now benefit from your VRR hardware.
You won’t see the slider unless your system has all of the following. If any of these are missing, you will not see the toggle and the feature will not be enabled for you.
- Windows Version 1903 or later
- A G-SYNC or Adaptive-Sync capable monitor
- A GPU with WDDM 2.6 or above drivers, that supports G-SYNC / Adaptive-Sync and this new OS feature
This feature is disabled by default, but you can turn it on and try the feature out. If you run into any unexpected issues while gaming, turn the feature off and see if that resolves the issue for you. Thanks SH SOTN for this news submit.
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Senior Member
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For Nvidia GPU's, you need drive 435.27
For AMD GPU's, you need the latest drivers
435.27 Windows 10 x64 build 1903 18362.145

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I'm still on 1709 for networking reasons, but I'm curious if anybody knows what this means for the Samsung 2018 line of TV's with some Freesync kind of support.
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No it's for all DX11 Games (only DX11.x ATM):
Microsoft has announced that it has added a new toggle in Graphics Settings for variable refresh rate in the latest version of Windows 10, Windows 10 Version 1903.
This option will allow you to have variable refresh rates in all DX11 games in full-screen mode, regardless of whether a game was previously compatible with VRR or not.
As Microsoft noted:
“This new OS support is only to augment these experiences and does not replace them. You should continue to use FreeSync / Adaptive-Sync normally.
This toggle doesn’t override any of the settings you’ve already configured in the FreeSync or Adaptive-Sync control panels.
This new toggle enables VRR support for DX11 full-screen games that did not support VRR natively, so these games can now benefit from your VRR hardware.”
In order to take advantage of this new setting, you’ll need Windows Version 1903 or later, a
FreeSync or Adaptive-Sync capable monitor and a GPU with WDDM 2.6 or above drivers that supports FreeSync/Adaptive-Sync and this new OS feature.
Must be Like this (supported by H/W)

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You need to go to System app/Display then Graphics Setting, it should pop up.
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Option not showing up for me. v1903, Acer x34p G-Sync monitor and dxdiag shows WDDM 2.6. Using nvidia driver 430.86