Previous research has determined the relevance of video games for adolescents; however, it has not been possible to establish differences in usage patterns and certain psychological variables according to gender, parental control, academic performance, physical activity level or game type, nor the relationship between these variables. For this reason, the aims of this research were as follows: (a) to determine the differences in the gaming variables and the psychological variables related to video games according to gender, the closest environment, the academic performance and the level of physical activity; and (b) to determine which gaming variables and behavioral variables influence psychological variables in adolescents. A descriptive, cross-sectional study was carried out involving 2567 adolescents (mean age: 15.06 ± 2.81 years). Participants completed eight questionnaires on the study variables. The results showed that males play more video games than females; play different types of games and on different platforms; and have more psychological problems than females. Having separated parents and having a greater parental control over video game use is associated with more time spent playing video games. Poorer academic performance is related to playing shooters and open-world games, as well as with a more negative emotional response. However, playing shooters and sport and racing games is related to more physical activity. Playing online games, mainly with strangers, is related to higher addictive and problematic uses. In addition, the times of use during the week and on weekends, especially on weekends, stand out as predictors of most psychological variables related to video games in adolescents. This study provides further scientific evidence on the role of certain behavioral and game-related variables in the relationship between video games and well-being. In addition, it highlights the importance of analyzing in the future those video game players who do not have a problematic or addictive use of video games, but who play frequently without any associated problem. From a practical perspective, the promotion of video games with social and cooperative components, or those that promote physical activity, could be related to social and psychological benefits.