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I tried FattyJoker's suggestion and the GlovePie suggestion for this. No luck.

When I was trying to get the game running on Win10 I came across Blood2StarterKit.7z. 9MB. It's on moddb. From what I can see it's the whole game with dgvoodoo and the WIDESCREEN.REZ, but doesn't include the game's 3 large files. BLOOD2.REZ, BLOOD2NM.REZ and SOUND.REZ. So I added those myself.

Changing the weapons with the wheel was working OK. Wanting to change the inventory previous/next, I accidentally changed weapons previous/next. That screwed changing weapons with the wheel. I will add that weapon change with the mouse wheel was selected in the menu.

So I just ended the game and grabbed the autoexec.cfg from Blood2StarterKit and started the game again and the mouse wheel worked again. Before I add the next bit I will add that I'm in the UK so it's a UK keyboard I'm using just in case it matters. So, it was then that I noticed that previous weapon is set to ; whilst next weapon is set to ' as well as mouse1, which is strange as Fire (weapon) is also set to mouse1. Hitting ; does work for previous weapon, but if I hit ' I get the game's console.

I decided not to play around any more to see what's going on. Maybe related to what HenitoKisou said about old mice?
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HaloFighter92: I have the option set to on from the menu, it doesn't work. I try to add lines myself in autoexec and it didn't work either. How do I get the mousewheel to work for Blood 2? Thanks.
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FattyJoker: Whoever stumbles upon this thread googling, the solution from Shogo section works just as fine for Blood II (both games using the same good old LithTech 1 engine): open autoexec.cfg file in your game's directory with Notepad or any text editor, and add the following line

rangebind "##mouse" "Wheel" -10000.000000 -0.100000 "NextWeapon" 0.100000 10000.000000 "PrevWeapon"

Mind that any settings changes will likely overwrite your autoexec.cfg and erase the added line, thus make sure to fiddle with your options through menus first. This command binds "next weapon" to "wheel down" and "previous" to "up", for opposite simply switch "NextWeapon" and "PrevWeapon" places.
Thank You Very Much!