Hot reload in general is difficult to make work in something that is mainly compiled, for example it does not work with F# right now, but there is someone in community working on making it a possibility. It's regular activities you'd see in other ecosystems.

E.g. I think NetCoreDbg, as an alternative to closed vsdbg that has usage restrictions, works well enough to fully enable the standard workflow when using VSCodium/Cursor/Neovim/etc. I know people use the latter with both C# and F# without sacrificing user experience in comparison to languages like Rust. It's just text editor, language server + debugger integration and CLI. You would hear about "refactorings" and "advanced features" from those who are used to more IDE-like experience provided by VS or Rider but, for example, many refactorings are also available in VSC/VSCodium because they are just a feature of the language server based on Roslyn analyzers and auto-fixers. It works with anything that integrates that and the language server itself ships with SDK to my knowledge.

All in all, the tooling situation is pretty good with multiple IDEs, commercial and community tools offered to be able to program in .NET languages, most languages HN loves to sign praises to do not have this. The same applies to GUI frameworks too - it's funny to read how .NET is "anti-linux" because out of AvaloniaUI, Uno, MAUI and a bunch of smaller libraries MAUI does not happen to target Linux. Some people just like to hate something, and if the reason for that goes away they come up with a new one.