Do you need Visual Studio for its C compiler? Or can you get by without it (eg, is there another compile you could use to build native stuff)?
The other aspect of this question is how often this actually is needed. I'd say it really depends on the type of development you are doing. But you can expect that any project with a sufficiently large amount of dependencies will have at least one that requires building this way. But I am surprised how often this isn't the case, and often those modules are soft dependencies.
[0]: https://github.com/Microsoft/nodejs-guidelines/blob/master/w...
If I wasn't on a spotty network ATM I'd dig through my old blog posts to find where I wrote about it. In general though, if you can get a free version of one of the VS flavors, you'll save a lot of hassle just installing that.