Setting up raylib in Visual Studio is very simple.

1. Download and install Visual Studio (note, if you have used unity in the past, you probably have this already)
2. Create a new C# Console Application Project from the File -> New -> Project Menu
   1. Select .net Core 3.1 for your target framework
   2. If you do not have .net Core 3.1 download an install it.
3. After the project is created, Right click on the project and choose "managed nuget projects"
4. Choose the Browse tab and type in "Raylib".
5. Select the "raylib-cs" package from the list and choose 'install' from the panel on the right.
6. Build your raylib game in C# by using the Raylib_cs library.

A simple main program looks like this

using System;

using Raylib_cs;

namespace ConsoleApp
{
    class Program
    {
        static void Main(string[] args)
        {
            Raylib.InitWindow(800, 600, "TEST");

            while (!Raylib.WindowShouldClose())
            {
                Raylib.BeginDrawing();
                Raylib.ClearBackground(Color.RAYWHITE);

                Raylib.DrawText("Hello C# Window", 10, 10, 20, Color.RED);

                Raylib.EndDrawing();
            }
            Raylib.CloseWindow();
        }
    }
}