2005 Tacoma 4.0 Auto 4x4

Have 250k miles on this truck, frames good surprisingly any other common issues with the truck to be aware of? Sometimes I have a rough shift or a little rough idle but other than that the truck seems to be running pretty good for its age and mileage.

 

Head gaskets on the 05's were know to have issues.
You don't do anything about it. Just wait until the they blow. (If they blow)

I'd clean the throttle body, change the plugs, and drain and fill the transmission.
That would be a good start with addressing the issues you stated.