His second wife also happened to be his first cousin. Interestingly, they shared the "Einstein" surname (their fathers were also first cousins) and would have shared it at the time they married, but Elsa had already married and divorced by that point.
Not necessarily; their mothers were sisters, and their fathers were cousins on their father's side (so both Albert and Elsa had the surname "Einstein").
The actual consequences of inbreeding are overblown by most. First cousins have a 12.5 percent chance of passing on a set of recessive gene expressions, which is about the same chance as an ordinary mother in her 40s.