diff --git a/src/cpptools.ts b/src/cpptools.ts
index 7c8911e75..06246df78 100644
--- a/src/cpptools.ts
+++ b/src/cpptools.ts
@@ -431,6 +431,11 @@ export class CppConfigurationProvider implements cpt.CustomConfigurationProvider
       throw new MissingCompilerException();
     }
 
+    const buildType = opts.cache.get('CMAKE_BUILD_TYPE');
+    if (buildType) {
+      opts.activeBuildTypeVariant = buildType.as<string>();
+    }
+
     const targetFromToolchains = comp_toolchains?.target;
     const targetArchFromToolchains = targetFromToolchains ? parseTargetArch(targetFromToolchains) : undefined;
 
diff --git a/src/drivers/codemodel-driver-interface.ts b/src/drivers/codemodel-driver-interface.ts
index 0fe0ba76b..3bf360be1 100644
--- a/src/drivers/codemodel-driver-interface.ts
+++ b/src/drivers/codemodel-driver-interface.ts
@@ -132,7 +132,7 @@ export interface CodeModelContent {
    */
   activeTarget: string|null;
   /**
-   * The active build_type variant
+   * CMAKE_BUILD_TYPE for single config generators, and build config for multi config ones.
    */
   activeBuildTypeVariant: string|null;
   /**
diff --git a/src/drivers/driver.ts b/src/drivers/driver.ts
index 64eaa0e70..ff9becbe9 100644
--- a/src/drivers/driver.ts
+++ b/src/drivers/driver.ts
@@ -684,6 +684,9 @@ export abstract class CMakeDriver implements vscode.Disposable {
    */
   get currentBuildType(): string {
     if (this.useCMakePresets) {
+      if ((this.isMultiConfig || this.isMultiConfFast) && this._buildPreset?.configuration) {
+        return this._buildPreset.configuration;
+      }
       const buildType = this._configurePreset?.cacheVariables?.['CMAKE_BUILD_TYPE'];
       if (util.isString(buildType)) {
         return buildType;
@@ -696,8 +699,12 @@ export abstract class CMakeDriver implements vscode.Disposable {
     }
   }
 
-  get isMultiConf(): boolean {
-    return this.generatorName ? util.isMultiConfGenerator(this.generatorName) : false;
+  private _isMultiConfig: boolean = false;
+  get isMultiConfig(): boolean { return this._isMultiConfig; }
+  set isMultiConfig(v: boolean) { this._isMultiConfig = v; }
+
+  get isMultiConfFast(): boolean {
+    return this.generatorName ? util.isMultiConfGeneratorFast(this.generatorName) : false;
   }
 
   /**
@@ -1229,7 +1236,7 @@ export abstract class CMakeDriver implements vscode.Disposable {
         telemetryProperties = {
           CMakeExecutableVersion: cmakeVersion ? util.versionToString(cmakeVersion) : '',
           CMakeGenerator: this.generatorName || '',
-          ConfigType: this.isMultiConf ? 'MultiConf' : this.currentBuildType || '',
+          ConfigType: this.isMultiConfFast ? 'MultiConf' : this.currentBuildType || '',
           Toolchain: this._kit?.toolchainFile ? 'true' : 'false', // UseToolchain?
           Trigger: trigger
         };
@@ -1354,7 +1361,7 @@ export abstract class CMakeDriver implements vscode.Disposable {
 
     const allowBuildTypeOnMultiConfig = config.get("cmake.setBuildTypeOnMultiConfig") || false;
 
-    if (!this.isMultiConf || (this.isMultiConf && allowBuildTypeOnMultiConfig)) {
+    if (!this.isMultiConfFast || (this.isMultiConfFast && allowBuildTypeOnMultiConfig)) {
       // Mutliconf generators do not need the CMAKE_BUILD_TYPE property
       settingMap.CMAKE_BUILD_TYPE = util.cmakeify(this.currentBuildType);
     }
@@ -1416,7 +1423,7 @@ export abstract class CMakeDriver implements vscode.Disposable {
     const child = await this._doCMakeBuild(target, consumer);
     const timeEnd: number = new Date().getTime();
     const telemetryProperties: telemetry.Properties | undefined = this.useCMakePresets ? undefined : {
-      ConfigType: this.isMultiConf ? 'MultiConf' : this.currentBuildType || ''
+      ConfigType: this.isMultiConfFast ? 'MultiConf' : this.currentBuildType || ''
     };
     const telemetryMeasures: telemetry.Measures = {
       Duration: timeEnd - timeStart
diff --git a/src/extension.ts b/src/extension.ts
index 13c205bf7..62b22a696 100644
--- a/src/extension.ts
+++ b/src/extension.ts
@@ -127,6 +127,7 @@ class ExtensionManager implements vscode.Disposable {
         subs.push(new_cmt.onCodeModelChanged(FireLate, () => this._updateCodeModel(cmtFolder)));
         subs.push(new_cmt.onTargetNameChanged(FireLate, () => this._updateCodeModel(cmtFolder)));
         subs.push(new_cmt.onLaunchTargetNameChanged(FireLate, () => this._updateCodeModel(cmtFolder)));
+        subs.push(new_cmt.onActiveBuildPresetChanged(FireLate, () => this._updateCodeModel(cmtFolder)));
         this._codeModelUpdateSubs.set(new_cmt.folder.uri.fsPath, subs);
       }
       rollbar.takePromise('Post-folder-open', {folder: cmtFolder.folder}, this._postWorkspaceOpen(cmtFolder));
@@ -209,7 +210,8 @@ class ExtensionManager implements vscode.Disposable {
         this._codeModelUpdateSubs.set(cmtFolder.folder.uri.fsPath, [
           cmtFolder.cmakeTools.onCodeModelChanged(FireLate, () => this._updateCodeModel(cmtFolder)),
           cmtFolder.cmakeTools.onTargetNameChanged(FireLate, () => this._updateCodeModel(cmtFolder)),
-          cmtFolder.cmakeTools.onLaunchTargetNameChanged(FireLate, () => this._updateCodeModel(cmtFolder))
+          cmtFolder.cmakeTools.onLaunchTargetNameChanged(FireLate, () => this._updateCodeModel(cmtFolder)),
+          cmtFolder.cmakeTools.onActiveBuildPresetChanged(FireLate, () => this._updateCodeModel(cmtFolder))
         ]);
         rollbar.takePromise('Post-folder-open', {folder: cmtFolder.folder}, this._postWorkspaceOpen(cmtFolder));
       }
@@ -734,15 +736,20 @@ class ExtensionManager implements vscode.Disposable {
           }
         }
 
+        const isMultiConfig = !!cache.get('CMAKE_CONFIGURATION_TYPES');
+        if (drv) {
+          drv.isMultiConfig = isMultiConfig;
+        }
+        const actualBuildType = isMultiConfig && cmt.useCMakePresets ? cmt.buildPreset?.configuration || null : cmt.activeVariant;
         const clCompilerPath = await findCLCompilerPath(env);
         this._configProvider.cpptoolsVersion = cpptools.getVersion();
         let codeModelContent;
         if (cmt.codeModelContent) {
           codeModelContent = cmt.codeModelContent;
-          this._configProvider.updateConfigurationData({ cache, codeModelContent, clCompilerPath, activeTarget: cmt.defaultBuildTarget, activeBuildTypeVariant: cmt.activeVariant, folder: cmt.folder.uri.fsPath });
+          this._configProvider.updateConfigurationData({ cache, codeModelContent, clCompilerPath, activeTarget: cmt.defaultBuildTarget, activeBuildTypeVariant: actualBuildType, folder: cmt.folder.uri.fsPath });
         } else if (drv && drv.codeModelContent) {
           codeModelContent = drv.codeModelContent;
-          this._configProvider.updateConfigurationData({ cache, codeModelContent, clCompilerPath, activeTarget: cmt.defaultBuildTarget, activeBuildTypeVariant: cmt.activeVariant, folder: cmt.folder.uri.fsPath });
+          this._configProvider.updateConfigurationData({ cache, codeModelContent, clCompilerPath, activeTarget: cmt.defaultBuildTarget, activeBuildTypeVariant: actualBuildType, folder: cmt.folder.uri.fsPath });
           this._projectOutlineProvider.updateCodeModel(
             cmt.workspaceContext.folder,
             codeModelContent,
diff --git a/src/util.ts b/src/util.ts
index cc12c245c..42cac4e71 100644
--- a/src/util.ts
+++ b/src/util.ts
@@ -314,8 +314,11 @@ export function splitCommandLine(cmd: string): string[] {
   return quoted_args!.map(arg => arg.replace(/\\(")/g, '$1').replace(/^"(.*)"$/g, '$1'));
 }
 
-export function isMultiConfGenerator(gen: string): boolean {
-  return gen.includes('Visual Studio') || gen.includes('Xcode');
+/**
+ * This is an initial check without atually configuring. It may or may not be accurate.
+ */
+export function isMultiConfGeneratorFast(gen: string): boolean {
+  return gen.includes('Visual Studio') || gen.includes('Xcode') || gen.includes('Multi-Config');
 }
 
 export class InvalidVersionString extends Error {}