Multimodal misinformation is increasingly crafted to look convincing by pairing a textual claim with an image that appears to "prove" it. Yet in practice, building effective detectors often hinges on a small set of design choices that are rarely examined in a controlled way. In this paper, we conduct a large-scale study of multimodal design choices for misinformation detection with over 3,375 experiments- spanning three benchmark datasets and a broad range of pre-trained vision and language backbones. Through systematic comparisons and targeted robustness analyses, we distill practical guidance on which design choices help, when do they fail silently, and what aspects of the pipeline most strongly shape model behavior, answering 4 key Research Questions (RQs). We aim to provide a reliable foundation for designing stronger and more dependable multimodal misinformation detection systems, thus contributing to the broader research community.

Memes often derive their harmful, hateful, or sarcastic meaning from small but decisive visual, textual, or cross-modal cues. Existing multimodal classifiers can miss such evidence when relying mainly on global image-text representations. We introduce MemeCF, a cue-focused benchmark of 9,895 memes across harm, hate, and sarcasm, with annotations identifying the modality and rationale of the pivotal evidence. We also propose MemePIVOT, a local-global architecture for meme classification. MemePIVOT uses frozen CLIP features, unbalanced optimal transport to align words with image patches while allowing irrelevant evidence to remain unmatched, and an evidential fusion head to combine local grounding with global meme context under uncertainty. Experiments on HarMeme, PrideMM, and MemeCF show consistent gains over strong text-only, image-only, multimodal, and vision-language baselines. Cross-dataset and ablation results further show that explicit pivotal-evidence modeling improves robustness and contributes meaningfully beyond global multimodal representations. Our code and dataset are publicly available at https://github.com/AkshitSharma1/MemePIVOT