Using the Arduino Builder
If you prefer to use the Arduino Builder instead of a standard c++ build you can select "Arduino-Builder" in the build system options on the settings tab.
If you select this option VisualTeensy will generate a slightly different project structure. Instead of a src/main.cpp it will generate a .ino file with the same name as the project folder and place it in the project root. Also disables the library tab will be disabled since the Arduino Builder will search for the libraries according to the Arduino rules. The generated makefile will simply call the Arduino Builder build the project.
Test
├── makefile
├── Test.ino
├── .vscode
│ ├── c_cpp_properties.json
│ └── tasks.json
└── .vsteensy
├── build
└── vsteensy.json
Note: VisualTeensy will never delete or override any source files. Thus, if you change this setting for an existing project you will have both a 'project'.ino and a 'src/main.cpp' file in the project. Since both files contain setup() and loop() you may get compile errors. Depending on the project type please delete either main.cpp or 'project'.ino manually in this case.