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1. Try using this ROMRC, it includes the necessary file specifications:
http://www.dcemu.co.uk/vbulletin/showthread.php?t=37423
2. There is not much you can do at the moment. Maybe try creating a CD with only AES4ALL + a dummy file + your Metal Slug X game on it and see if the lag is a bit shorter. Also I recommend not to play in 2 player mode as that will make the problem worse. In my opinion it runs very good in 1 player mode though.
Since Metal Slug X is basicly just a remix of Metal Slug 2 which is available for NeoGeoCD, you could use the Neo4All/CD emulator to play that instead. Metal Slug 1 and 2 run perfectly and without lag. Neo4All/CD recently also saw a new update with a great speed and compatibility improvement:
http://www.dcemu.co.uk/vbulletin/showthread.php?t=51603
Other than that you could wait for the next version of AES4All. This next version will make allow a game to use more of the Dreamcast's RAM
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