TinyCLR OS allows developers to debug tiny IoT device just like you would debug an application on a full PC, right from within Visual Studio, over USB or Serial. Set breakpoints, step through code, and examine variables without the need for specialized hardware or software.
By default, the system checks the MOD pin to determine the debug interface, USB or Serial. The user has the option to disable MOD pin feature and force (or disable) the debug interface. See Device Info for details.
Information on using the Visual Studio debugger can be found in Microsoft's documentation here.