I've only used the default selection, whatever it is in VS Code. Even paid for a year at one point as I was first using it with some SQL schema generation and it was pretty useful, kind of as a super auto-complete.

If the default option isn't at least arguably the best option I can't really speak to that. I would suggest that maybe metrics on a given set of technologies be done and that based on the project in use, that it should choose the best option dynamically by default. Such as C#+MS-SQL vs Node+Postgres vs Python+Matlab+DuckDB.