Maybe it was because I already had some of the necessary dependencies and tools installed, but for me it was as simple as installing the PlatformIO extension in VSCode and clicking the “new project” button. After selecting the board I wanted to use, it automatically downloaded the necessary cores and toolchains and initialized the config file and a basic main.cpp file. Everything just worked.
I already used VSCode as my main editor before, but I gave PlatformIO a try because of their debugging support. I must say it's quite impressive: I have the two SWD pins of an Arduino Nano 33 BLE connected to an ST-Link adapter, and it allows me to set breakpoints, inspect variables, single-step through the code, step through the assembly, inspect the registers (including peripheral registers with meaningful names), read any address in RAM, etc. Pretty much anything you can do with a standard (non-embedded) debugger. It already saved me a lot of time, being able to just hover over a variable name in your IDE to see its value is orders of magnitude faster than adding a print statement and recompiling+uploading every time you want to inspect a variable.
Are there any plans to include an SWD header on future Teensies? I've seen some articles about breaking out the pins on T3, but they were quite destructive, and as far as I could tell from the forum threads here, the T4 doesn't allow SWD debugging at all because of how its fuses are configured.
Given how easy it is to start a debugger with PlatformIO, and since Arduino also seems to be adding debugging support in their Arduino Pro IDE, it could be a nice feature to have on a Teensy as well.