You can do a lot of "native" windows development from modern C#/.NET via win32 interop.
Newer C# features like ref returns, structs, spans, et. al., make the overhead undetectable in many cases.
https://github.com/prasannavl/WinApi
https://github.com/microsoft/CsWin32
Exactly, the major pain point remains the .NET allergy from Windows team, but it is workable.
Exactly, the major pain point remains the .NET allergy from Windows team, but it is workable.