I think Carmack was mostly talking about regular Visual Studio as his IDE of choice, though. Not VSCode.
(agreed though. VS has been a beacon of light inside MS even in its darkest periods.)
Most Windows programmers I know (not a lot) use VS for the ease of integration with all things .NET and Microsoft.
It was a surprisingly bad experience - weirdly slow even on a high performance PC and so much clutter by default.
Tried out VS 2022 just now. First impressions are better.
VS seems to be a WPF app nowadays, so I assume the UI is written in C#.
Either the whole thing freezes and becomes unresponsive, or intellisense stops working, or (often) both.
Sublime Text + GDB + RR is my no-bullshit setup right now and I love it. A mouse interface to GDB would be nice, but I can live without it.