There will be some poofiness caused by the stitching compressing the batting. It is just part of the nature of the beast.
I also don't see any wrinkles or pleats. I would leave it.
I have a a machine with a built-in walking foot, and I stitch all my rows in the same direction. My reasoning for that is that if it is going to "pull" - it will all go the same way. So far, I've only done straight-lline and stitch in the ditch quilting, but that quilting looks respectable on both sides.