Note that I am a new user, so excuse any "operator error" here. Note that some of these issues might be due to Windows 11.
I was able to install the extension and managed to get somewhere after installing Arduino IDE version 2.0.3, which I did not know was a pseudo requirement.
I was able to get a test program to run, but it was a little bumpy due to ESP32 reset issues. If it matters, this is an Adafruit Matrix Portal M4 with an ESP32-WROOM-32E chip.
Intellisense seems to work ok, but I haven't done much more than a hello world at this point.
Once I got past the issues below, I was able to connect to the board, upload a program, and the serial monitor works great.
Immediate issues:
Board Manager is messed up. I can install boards within Arduino IDE and VMicro does see it, but the board manager within VS is blank.
https://capture.dropbox.com/AZy34wmnJoVTNKbY Word wrap on some of the menus and tooltips doesn't seem to be working, so things are cut off.
Example:
Configure IDE Locations window.
https://capture.dropbox.com/7KeiY8fvHgXRMIq4 I was not able to get a screenshot of tooltips, but the one for the Dtr button on the Serial monitor window was one of them. Specifically the left side gets cut off as it goes out of view entirely. Normally tooltips start at where the mouse is, unless if it is too far to the right or something, so the left side of the tooltip box lines up with the arrow. This one does not and can get cut off as it tries to make the tooltip the entire width of your screen instead of a less wide version with word wrap.
I will continue to play with it on and off this week and will let you know what else I find out. I am just happy I managed to get this far!