There are some subtle differences between it and Visual Studio Code. The main one is the not having access to the VisualStudio market place. The C/C++ template isn’t there but instead is installed by default.
However I have found that the tasks and launch json files created from the F1 menu don’t have the C++ choices. What this means is that you have to get them from an official Visual Studio source, like Visual Studio Code installed on 64-bit Windows/Ubuntu/Mac.
I’d already done this so I used WinSCP to send them via ssh from my Windows box to the Pi. It’s a slight irritation but once you’ve got them setup it works ok. I can build applications haven’t got debugging working yet though.
There is an alternate Extensions Marketplace which has 266 items in it. That’s a screenshot of the programming language extensions.