I have just upgraded from visual Studio 2019 to 2022 version and in the player settings I have 2 options .Net Core 2.1 and .Net Framework. Why is there no 4.x version? I use Unity 2021 LTS
This may help you with intellisense and possibly other Visual Studio integration problems:
Sometimes the fix is as simple as doing Assets → Open C# Project from Unity. Other times it requires more.
Other times it requires you also nuke the userprefs and .vsconfig and other crufty low-value high-hassle files that Visual Studio tends to slowly damage over time, then try the above trick.
Barring all that, move on to other ideas:
Also, try update the VSCode package inside of Unity: Window → Package Manager → Search for Visual Studio Code Editor → Press the Update button
Also, this: No suggestions in Vscode
also the old .net 4.x dropdown was renamed to .net framework at some point in 2021.x i think.