Generative retrieval methods utilize generative sequential modeling techniques, such as transformers, to generate candidate items for recommender systems. These methods have demonstrated promising results in academic benchmarks, surpassing traditional retrieval models like two-tower architectures. However, current generative retrieval methods lack the scalability required for industrial recommender systems, and they are insufficiently flexible to satisfy the multiple metric requirements of modern systems. This paper introduces PinRec, a novel generative retrieval model developed for applications at Pinterest. PinRec utilizes outcome-conditioned generation, enabling modelers to specify how to balance various outcome metrics, such as the number of saves and clicks, to effectively align with business goals and user exploration. Additionally, PinRec incorporates multi-token generation to enhance output diversity while optimizing generation. Our experiments demonstrate that PinRec can successfully balance performance, diversity, and efficiency, delivering a significant positive impact to users using generative models. This paper marks a significant milestone in generative retrieval, as it presents, to our knowledge, the first rigorous study on implementing generative retrieval at the scale of Pinterest.