Exit menu options: The Exit menu normally pops up when you press the Cancel/Escape key when no other menus or popups are showing. It presents options for exiting PinballY and for a few other system options that don't belong in the main "game" menu. These options let you control whether this menu is enabled and which commands it includes.
If the Exit menu is disabled, you can still access its commands via the Operator menu, which you can display via the "service buttons" inside the coin door. The Operator menu is accessed from the service buttons specifically because those buttons are behind the (normally locked) coin door, specifically to limit access in a public setting.
"Cancel/Escape" button behavior in Exit menu: This controls what the Cancel/Escape button does while the Exit menu is being displayed.
This option might seem bizarre at first glance - why would you want to make the Cancel button do the opposite of what it normally does? The rationale is that you activate the Exit menu in the first place by pressing the Cancel button, so in a way it's already acting like a "select" button in this context. Some people find it more natural for it to keep acting like a "select" button throughout the Exit menu. This option lets you set it up to match whichever sense seems more natural to you.