Found the problem, originally VS 2019 was installed without ASP.NET and .NET Cross-Platform Development selected. Only .NET Desktop Development was selected. I created my ASP.NET projects without the proper modules installed. After noticing this I went back installed both missing modules however that did not fix the issue. Some linkages in the backend of VS 2019 weren't being made.
Final solution - reinstall VS 2019 with correct modules from the start (didn't try repair first). Now all the helpers, code-complete, Intellicode, it all works.