It varies on the language/project. I tend to set my Build Task (Ctrl+Shift+B) to the most useful task and F1 > Run task my way to the others. That doesn't feel much more inefficient than switching to an external terminal (though as the internal terminal with Ctrl+` gets better I may start using it more often).

The F5 debug support is great in Node and .NET Core and there are extensions to support other language debugging. (I've heard the Go and Rust ones in particular are great, though I don't work in either language myself.)