I've been using regular --alt-preset standard for quite a long time, on some crazy musical material (analog synthesizers, sometimes encoding pure square waves, sine waves, pulse waveforms, white noise, weird combinations, etc).
It all sounds good to me. I can think of *one* time where extreme or insane was a little better (it was a strangely modulated white noise sample), and that was only with the Winamp equalizer *on* (no idea why, but it was mangling that waveform). When I turned the WinAMP EQ off, it sounded OK with --a-p standard too (still a bit metallic, but pretty good).
I am constantly amazed at how good --alt-preset standard is with 99.9% of music, and a lot of it at 192kbps or below. *Very* rarely do I hear even a slight improvement with extreme or insane (maybe if I were listening carefully for problems, I would find a few more). If you take the preset names as a hint, it should be obvious that there's no need to get extreme, and even less to go insane.

Edit (P.S.) if somebody wants that strange white noise sample for testing, I could donate it (but you'd have to accept LPAC format, I don't use FLAC).