There are three options:
- Research Consent Document: Allow 23andMe researchers to use your genetic information to study a variety of topics, stripped of name and contact information and aggregated. May involve 3rd party collaborations including non-profits, pharmaceutical companies, and academic institutions. Results of research may be shared publicly.
- Health Records Project: Connect your data to your healthcare providers using "Human API"
- Individual Data Sharing: This is a supplement of the first one and includes additional data points, most of which come from interacting with the website.
This information is available directly on the page I referenced, not hidden in a ToS document.
The system will prompt the user to decide at enrollment time - they don't have to seek it out, but it certainly is not opt-out.
There's also a few dark patterns to confuse the user to check the box. Put it next to a "Accept T&C" and people think they have to check it.
Or word in a vague way. I doubt it said "We can sell your DNA to 3rd party who can then patent it".