Hi Keith,
Assuming you're running on Windows with an ASP.NET app, the two most commonly tuned parameters are:
1) max_client_cache in the soss_params.txt file: This setting adjusts the size of the internal cache of deserialized objects within the .NET client libraries--the libraries basically hold on to references of recently requested objects. So when you read a big object, this client-side cache dramatically reduces response time by eliminating the network and deserialization overhead. It may be that you have too many large objects for this in-process cache to operate effectively, so increasing its size may help.
By default the max_client_cache is set to 100000KB (100 MB), so try increasing this if you have memory to spare on your web servers. Changes to the soss_params.txt file will take effect when the ScaleOut StateServer service is restarted, and your app pools will then pick up the change from the SOSS service the next time they're recycled.
Also, if you haven't already, consider configuring your load balancer to use session affinity. If a user's requests always (or, at least, usually) hit the same web server then it can make better use of the client cache described above. Using affinity isn't strictly required by SOSS, but if a user's web requests always go to the same web server then the odds of a client cache hit will improve, which can reduce serialization/network overhead.
To measure whether these changes have an effect, consider monitoring the "ScaleOut StateServer Service\Client Cache Read Hits" performance counter in Windows perfmon before and after you make the change.
2) max_svr_conn in the soss_client_params.txt file: If your web servers only have ScaleOut client libraries installed and are accessing remote, dedicated SOSS machines over the network then increasing max_svr_conn can increase throughput (assuming you have network bandwidth available). This setting is used to increase the number of simultaneous connections that your web servers have open to remote SOSS servers (if you run the SOSS service directly on your web servers then this setting will have no effect). By default the value is 4, but it can be increased to 32 simultaneous connections.
Changing values in the soss_client_params.txt will take effect the next time your app pools are recycled.
Having said all this, we're really only taking a stab in the dark here with so little information... if you can pinpoint a bottleneck on a specific resource (Network? CPU? ...which process?) then we may be able to offer more targeted advice.