To be honest what I don't like is the neverending march of tiled frames for everything - the whole program is one frame, then i have one frame for the code, one frame for the solution explorer, two more frames for error list and output, another one for properties and so on. A lot of screen space is taken by just blank spaces or dividers.
Another thing that I didn't like was that the 'Comment selection' option is hidden in Edit -> Advanced -> Comment selection. You also have to use two keyboard shortcuts in succession to comment something (Ctrl+K, Ctrl+C) and the uncomment shortcut is different (Ctrl+K, Ctrl+U). All this while Ctrl + / does nothing and could do both at the same time.
I often need the whole VS solution and not just the code when I need to copy paste the project to a different folder or a different machine.
The double-keystroke thing is a bit odd yes, and the menu is hidden a bit far away for ease of navigation. Still, it could be worse - it could be a RIBBON!
I use it with C++ and C# and I can't say stress enough how amazing it is to use with C++, compared to the teeth-pulling experience of using xcode for the same tasks (some of which are impossible in xcode, edit-and-continue for example, set next statement).