Just landed here, can confirm this worked on an M4 Mac Mini:
- Download the vscode-cpptools .vsix file for your system (ARM64 for MacOS in my case) from Releases · microsoft/vscode-cpptools · GitHub
- Open Cursor and install via Shift+CMD+P → Extensions: Install from VSIX
- Get the PlatformIO VSIX from Releases · platformio/platformio-vscode-ide · GitHub
- Install same a 2.
- Restart Cursor - done
Probably some more editor stuff to set up, but this got me building and uploading a PlatformIO Project to an ESP32-C3 from Cursor in under five minutes.