Sure you can. You technically can’t use the VS Code remote extension in Codium because of licensing reasons (tho people have packaged it for that marketplace anyway - and I’m not suggesting anyone do that, I am saying it has been done), but there is nothing stopping anyone from building a remote extension that uses the dev container spec.
I’m not debating that that isn’t a lot of extra work, but the spec itself is absolutely open for anyone else to integrate. I’d posit that the reason we haven’t seen alternatives (to my knowledge) to remote extension because of how much work is involved when most people (maybe not you, but most people), are comfortable just turning off the telemetry flag in VS Code rather than using Codium.
But if you’d rather use something like Nix, using something like devbox or devenv will achieve something similar to dev containers and that’s fine foo.