Open Ableton Live by double-clicking the icon for the application on your desktop. Alternatively, click "Start," "All Programs," then choose Ableton Live from the program list.
Go to the "Live Devices" panel on the left side of the screen, and click the arrow beside the instrument or effect that you want to use. A drop-down menu will appear, showing you all of the various patches for that device.
Move your mouse over the desired patch that you want to insert into your project, and drag it to the arrangement. If you are inserting an instrument preset, a midi channel will be automatically created. If you are inserting an effect preset, drag it to an audio track that has musical content on it already. Repeat for as many instruments and effects you wish to add.