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There needs to pe a standard that all editors understand. Propriatory answers like emacs don't count as some of us do not have the same editor religion.

Personally, I use markdown for comment content, not that IDEs do much with it, at least Markdown supports images with the `![alt text](filename)` syntax.

I think I've seen some tree-sitter grammars actually define injections such that their comment are rendered with markdown (but now I can't figure out where I saw that, maybe one of the Zed specific ones).

And there are Visual Studio plugins as well. I use one called Illuminated Comments to add images to my C++ comments.

You can also do in-line UML rendering and display with babel+plantuml.

TIL.