I’ve been getting the error Error updating Xcode project on my Mac when trying to open a storyboard using Xcode in Visual Studio, by right-clicking the storyboard and choosing Open With|Xcode Interface Builder.

Going to Help|Open Log Directory and then opening Ide.log I got a clue:

WARNING [2019-11-26 18:42:18Z]: Slow command update (28ms): Command:MonoDevelop.Ide.Commands.ViewCommands.OpenWithList, Method:MonoDevelop.Ide.Gui.Pads.ProjectPad.ProjectFileNodeCommandHandler.OnOpenWithUpdate, CommandTargetType:MonoDevelop.Ide.Gui.Pads.ProjectPad.ProjectFileNodeCommandHandler
ERROR [2019-11-26 18:42:22Z]: Error updating Xcode project
MonoDevelop.MacDev.ObjCIntegration.ObjectiveCGenerationException: Could not generate Objective-C code for action 'LanguagePicker_Activated' in class 'AppleWatchAlexa.WatchOSAppExtension.LaunguageInterfaceController' as the type 'System.nint'of its parameter 'sender' could not be resolved to Objective-C
...

For some reason it doesn’t like the System.nint in the generated code for the View Controller. I edited the generated code and removed the offending lines.

Before:

        [Action ("LanguageButton_Activated")]
        [GeneratedCode ("iOS Designer", "1.0")]
        partial void LanguageButton_Activated ();

        [Action ("LanguagePicker_Activated:")]
        [GeneratedCode ("iOS Designer", "1.0")]
        partial void LanguagePicker_Activated (System.nint sender);

        [Action ("LogoutButton_Activated")]
        [GeneratedCode ("iOS Designer", "1.0")]
        partial void LogoutButton_Activated ();

after:

        [Action ("LanguageButton_Activated")]
        [GeneratedCode ("iOS Designer", "1.0")]
        partial void LanguageButton_Activated ();

        [Action ("LogoutButton_Activated")]
        [GeneratedCode ("iOS Designer", "1.0")]
        partial void LogoutButton_Activated ();

I committed the cardinal sin of editing generated code, but at least now it opens!