GPIO configuration parameters include setting the pin as input or output, output mode as push-pull or open-drain, and pull-up/pull-down settings. Push-pull mode uses two MOSFETs to actively push or pull the output high or low, while open-drain uses one MOSFET that can only pull low and requires an external pull-up resistor. Pull-up or pull-down resistors are used to prevent floating inputs by connecting pins high or low when not driven. GPIO speed controls the slew rate for rise and fall times.