There are elements of genetic alteration, but for the most part it's not very prominent.
At least the widespread ones. Like people on the moon are going to be altered to not degenerate like a normal person would in low-gravity. They would still need suits to survive outside of the domed cities.
Anything extreme would be very, very expensive and limited to a few experiments in gene-tech. Not to mention mostly illegal.
But still, I'm sure most rich families would screen for genetic disorders and probably make sure that their children are genetically disposed to being healthy/intelligent/attractive.
“She'd become a governess. It was one of the few jobs a known lady could do. And she'd taken to it well. She'd sworn that if she did indeed ever find herself dancing on rooftops with chimney sweeps she'd beat herself to death with her own umbrella.”
― Hogfather