In nearly all cases, you will never need to touch that. It's for making sure some flags are set and others are unset.So if you have "S" out of "SA" checked it will only match if SYN is set and ACK is not set. This way it can match the first packet of a TCP handshake but not the later packets. That example is the default choice when that control is left alone at the default and the rule is for TCP.
pfctl -s rules