The intellisense from clangd is much better and faster than the Microsoft C++ extension, if you can set up a compile_commands.json. Although debugging still relies on the Microsoft extension. Although I don't think it's going to be hard to create an extension just for debugging (if it does not already exist?)

Yes, even on medium sized code bases (few 100K lines), the Microsoft C++ extension gets extremely slow. Clangd is a much better option.

Not just faster, I have never been able to get jump to declaration/definition/references to work reliably without clangd.

Is there a ‘right’ (or simple/direct) way to generate this using various buildchains? I remember setting this up so I could use Sublime with intellisense a while ago, and finding that I could only get it to generate with a specific compiler chain on windows (ninja I think?)

Minor annoyance to have to make my c make project generate buildchain files for a compiler I’m not using & copy that file into my project root to commit it- unrelated to the original question, but also annoying that I have to manually generate it every time I make significant codebase changes.

I've had the opposite experience with weird C++ projects from some customers that use external toolchains. For some reason even creating the compile_commands.json file with Bear doesn't work, while the proprietary Intellisense extension works out of the box without any configuration.

Lldb and rr (midas) have vscode extensions

I agree. It's way better. You can use the CodeLLDB extension for debugging.

https://github.com/vadimcn/codelldb

There are other third-party extensions which rely on the Microsoft C++ one. I have recently ran into this problem with my VSCodium setup.