Yeah, he meant VS. He even mentioned using an older version (6) as it is much faster on modern computers. Maybe he was referring to a friend of his, I don’t remember.
Most Windows programmers I know (not a lot) use VS for the ease of integration with all things .NET and Microsoft.
He doesn't use VS6 himself, he was most likely referring to Sean Barrett (aka "nothings") who worked on the original Thief as well as at RAD Game Tools and made the stb_ single header libraries. He has mentioned several times that he sticks with VC6 since he prefers the UX it has.
Yeah when he said this it I couldn't help but think of Sean Barrett/nothings.org coding videos. I was always shocked by people using VS6 post 2003 but it provides 50-75% of what people want from an ide these days. (A big proponent is inline debugging as mentioned) but I don't recall intellisense on this version, only keyword colouring and non trivial header exploration... Makes everything look bearable these days (even if run from a browser UI)
It's probably due to optimizations in high level code rather than the 32/64-bit aspect, but I'm just guessing. (To get that level of slowness you really have to fuck up at a higher level.)
VS seems to be a WPF app nowadays, so I assume the UI is written in C#.
Most Windows programmers I know (not a lot) use VS for the ease of integration with all things .NET and Microsoft.