diff --git a/pcsx2-gsrunner/Main.cpp b/pcsx2-gsrunner/Main.cpp
index 3317927ef4..80a4996a43 100644
--- a/pcsx2-gsrunner/Main.cpp
+++ b/pcsx2-gsrunner/Main.cpp
@@ -265,7 +265,8 @@ bool Host::AcquireHostDisplay(RenderAPI api, bool clear_state_on_fail)
 	if (!g_host_display)
 		return false;
 
-	if (!g_host_display->CreateDevice(wi.value()) || !g_host_display->MakeCurrent() || !g_host_display->SetupDevice() || !ImGuiManager::Initialize())
+	if (!g_host_display->CreateDevice(wi.value(), Host::GetEffectiveVSyncMode()) ||
+		!g_host_display->MakeCurrent() || !g_host_display->SetupDevice() || !ImGuiManager::Initialize())
 	{
 		ReleaseHostDisplay(clear_state_on_fail);
 		return false;
@@ -283,12 +284,6 @@ void Host::ReleaseHostDisplay(bool clear_state)
 	g_host_display.reset();
 }
 
-VsyncMode Host::GetEffectiveVSyncMode()
-{
-	// Never vsync! We want to finish as quickly as possible.
-	return VsyncMode::Off;
-}
-
 bool Host::BeginPresentFrame(bool frame_skip)
 {
 	if (g_host_display->BeginPresent(frame_skip))
diff --git a/pcsx2-qt/MainWindow.cpp b/pcsx2-qt/MainWindow.cpp
index 034a546de4..55a6fb18e6 100644
--- a/pcsx2-qt/MainWindow.cpp
+++ b/pcsx2-qt/MainWindow.cpp
@@ -2012,7 +2012,7 @@ DisplayWidget* MainWindow::createDisplay(bool fullscreen, bool render_to_main)
 
 	g_emu_thread->connectDisplaySignals(m_display_widget);
 
-	if (!g_host_display->CreateDevice(wi.value()))
+	if (!g_host_display->CreateDevice(wi.value(), Host::GetEffectiveVSyncMode()))
 	{
 		QMessageBox::critical(this, tr("Error"), tr("Failed to create host display device context."));
 		destroyDisplayWidget(true);
diff --git a/pcsx2-qt/QtHost.cpp b/pcsx2-qt/QtHost.cpp
index 194d717662..84154e9a85 100644
--- a/pcsx2-qt/QtHost.cpp
+++ b/pcsx2-qt/QtHost.cpp
@@ -931,26 +931,6 @@ void Host::ReleaseHostDisplay(bool clear_state)
 	g_emu_thread->releaseHostDisplay(clear_state);
 }
 
-VsyncMode Host::GetEffectiveVSyncMode()
-{
-	// Force vsync on when running big picture UI, and paused or no VM.
-	// We check the "running FSUI" flag here, because that way we set the initial vsync
-	// state when initalizing to on, avoiding an unnecessary switch.
-	if (FullscreenUI::HasActiveWindow() || (!FullscreenUI::IsInitialized() && g_emu_thread->isRunningFullscreenUI()))
-	{
-		const VMState state = VMManager::GetState();
-		if (state == VMState::Shutdown || state == VMState::Paused)
-			return VsyncMode::On;
-	}
-
-	// Force vsync off when not running at 100% speed.
-	if (EmuConfig.GS.LimitScalar != 1.0f)
-		return VsyncMode::Off;
-
-	// Otherwise use the config setting.
-	return EmuConfig.GS.VsyncEnable;
-}
-
 bool Host::BeginPresentFrame(bool frame_skip)
 {
 	if (!g_host_display->BeginPresent(frame_skip))
diff --git a/pcsx2/Frontend/CommonHost.cpp b/pcsx2/Frontend/CommonHost.cpp
index 7b76a473bb..6dba55ceb8 100644
--- a/pcsx2/Frontend/CommonHost.cpp
+++ b/pcsx2/Frontend/CommonHost.cpp
@@ -346,7 +346,6 @@ void CommonHost::OnVMDestroyed()
 void CommonHost::OnVMPaused()
 {
 	InputManager::PauseVibration();
-	FullscreenUI::OnVMPaused();
 
 #ifdef ENABLE_ACHIEVEMENTS
 	Achievements::OnPaused(true);
@@ -357,8 +356,6 @@ void CommonHost::OnVMPaused()
 
 void CommonHost::OnVMResumed()
 {
-	FullscreenUI::OnVMResumed();
-
 #ifdef ENABLE_ACHIEVEMENTS
 	Achievements::OnPaused(false);
 #endif
diff --git a/pcsx2/Frontend/CommonHotkeys.cpp b/pcsx2/Frontend/CommonHotkeys.cpp
index ce387af13a..59e33d64a8 100644
--- a/pcsx2/Frontend/CommonHotkeys.cpp
+++ b/pcsx2/Frontend/CommonHotkeys.cpp
@@ -46,7 +46,6 @@ static void HotkeyAdjustTargetSpeed(double delta)
 	EmuConfig.Framerate.NominalScalar = std::max(min_speed, EmuConfig.GS.LimitScalar + delta);
 	VMManager::SetLimiterMode(LimiterModeType::Nominal);
 	gsUpdateFrequency(EmuConfig);
-	GetMTGS().UpdateVSyncMode();
 	Host::AddIconOSDMessage("SpeedChanged", ICON_FA_CLOCK,
 		fmt::format("Target speed set to {:.0f}%.", std::round(EmuConfig.Framerate.NominalScalar * 100.0)), Host::OSD_QUICK_DURATION);
 }
diff --git a/pcsx2/Frontend/D3D11HostDisplay.cpp b/pcsx2/Frontend/D3D11HostDisplay.cpp
index 865fae31f7..e57caf9988 100644
--- a/pcsx2/Frontend/D3D11HostDisplay.cpp
+++ b/pcsx2/Frontend/D3D11HostDisplay.cpp
@@ -210,7 +210,7 @@ void D3D11HostDisplay::SetVSync(VsyncMode mode)
 	m_vsync_mode = mode;
 }
 
-bool D3D11HostDisplay::CreateDevice(const WindowInfo& wi)
+bool D3D11HostDisplay::CreateDevice(const WindowInfo& wi, VsyncMode vsync)
 {
 	UINT create_flags = 0;
 	if (EmuConfig.GS.UseDebugDevice)
@@ -314,7 +314,7 @@ bool D3D11HostDisplay::CreateDevice(const WindowInfo& wi)
 	}
 
 	m_window_info = wi;
-	m_vsync_mode = Host::GetEffectiveVSyncMode();
+	m_vsync_mode = vsync;
 
 	if (m_window_info.type != WindowInfo::Type::Surfaceless && !CreateSwapChain(nullptr))
 		return false;
diff --git a/pcsx2/Frontend/D3D11HostDisplay.h b/pcsx2/Frontend/D3D11HostDisplay.h
index 6eccfd8afe..57ff3dd143 100644
--- a/pcsx2/Frontend/D3D11HostDisplay.h
+++ b/pcsx2/Frontend/D3D11HostDisplay.h
@@ -43,7 +43,7 @@ public:
 	bool HasDevice() const override;
 	bool HasSurface() const override;
 
-	bool CreateDevice(const WindowInfo& wi) override;
+	bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) override;
 	bool SetupDevice() override;
 
 	bool MakeCurrent() override;
diff --git a/pcsx2/Frontend/D3D12HostDisplay.cpp b/pcsx2/Frontend/D3D12HostDisplay.cpp
index eec5aa02f1..cdb4c07ad3 100644
--- a/pcsx2/Frontend/D3D12HostDisplay.cpp
+++ b/pcsx2/Frontend/D3D12HostDisplay.cpp
@@ -136,7 +136,7 @@ void D3D12HostDisplay::SetVSync(VsyncMode mode)
 	m_vsync_mode = mode;
 }
 
-bool D3D12HostDisplay::CreateDevice(const WindowInfo& wi)
+bool D3D12HostDisplay::CreateDevice(const WindowInfo& wi, VsyncMode vsync)
 {
 	ComPtr<IDXGIFactory> temp_dxgi_factory;
 	HRESULT hr = CreateDXGIFactory(IID_PPV_ARGS(temp_dxgi_factory.put()));
@@ -190,7 +190,7 @@ bool D3D12HostDisplay::CreateDevice(const WindowInfo& wi)
 	}
 
 	m_window_info = wi;
-	m_vsync_mode = Host::GetEffectiveVSyncMode();
+	m_vsync_mode = vsync;
 
 	if (m_window_info.type != WindowInfo::Type::Surfaceless && !CreateSwapChain(nullptr))
 		return false;
diff --git a/pcsx2/Frontend/D3D12HostDisplay.h b/pcsx2/Frontend/D3D12HostDisplay.h
index 2377cf4fe8..696cece5c6 100644
--- a/pcsx2/Frontend/D3D12HostDisplay.h
+++ b/pcsx2/Frontend/D3D12HostDisplay.h
@@ -49,7 +49,7 @@ public:
 	bool HasDevice() const override;
 	bool HasSurface() const override;
 
-	bool CreateDevice(const WindowInfo& wi) override;
+	bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) override;
 	bool SetupDevice() override;
 
 	bool MakeCurrent() override;
diff --git a/pcsx2/Frontend/FullscreenUI.cpp b/pcsx2/Frontend/FullscreenUI.cpp
index 58a1369a70..cf537590b6 100644
--- a/pcsx2/Frontend/FullscreenUI.cpp
+++ b/pcsx2/Frontend/FullscreenUI.cpp
@@ -623,24 +623,6 @@ void FullscreenUI::OnVMStarted()
 	});
 }
 
-void FullscreenUI::OnVMPaused()
-{
-	if (!IsInitialized())
-		return;
-
-	// Force vsync on.
-	GetMTGS().UpdateVSyncMode();
-}
-
-void FullscreenUI::OnVMResumed()
-{
-	if (!IsInitialized())
-		return;
-
-	// Restore game vsync.
-	GetMTGS().UpdateVSyncMode();
-}
-
 void FullscreenUI::OnVMDestroyed()
 {
 	if (!IsInitialized())
@@ -652,7 +634,6 @@ void FullscreenUI::OnVMDestroyed()
 
 		s_pause_menu_was_open = false;
 		SwitchToLanding();
-		GetMTGS().UpdateVSyncMode();
 	});
 }
 
diff --git a/pcsx2/Frontend/FullscreenUI.h b/pcsx2/Frontend/FullscreenUI.h
index 6ac421e21e..4dd708a4b9 100644
--- a/pcsx2/Frontend/FullscreenUI.h
+++ b/pcsx2/Frontend/FullscreenUI.h
@@ -30,8 +30,6 @@ namespace FullscreenUI
 	bool HasActiveWindow();
 	void CheckForConfigChanges(const Pcsx2Config& old_config);
 	void OnVMStarted();
-	void OnVMPaused();
-	void OnVMResumed();
 	void OnVMDestroyed();
 	void OnRunningGameChanged(std::string path, std::string serial, std::string title, u32 crc);
 	void OpenPauseMenu();
diff --git a/pcsx2/Frontend/MetalHostDisplay.h b/pcsx2/Frontend/MetalHostDisplay.h
index aed0b5f5c2..436ca9a157 100644
--- a/pcsx2/Frontend/MetalHostDisplay.h
+++ b/pcsx2/Frontend/MetalHostDisplay.h
@@ -64,7 +64,7 @@ public:
 
 	bool HasDevice() const override;
 	bool HasSurface() const override;
-	bool CreateDevice(const WindowInfo& wi) override;
+	bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) override;
 	bool SetupDevice() override;
 	bool MakeCurrent() override;
 	bool DoneCurrent() override;
diff --git a/pcsx2/Frontend/MetalHostDisplay.mm b/pcsx2/Frontend/MetalHostDisplay.mm
index e51b567756..8e372cab9d 100644
--- a/pcsx2/Frontend/MetalHostDisplay.mm
+++ b/pcsx2/Frontend/MetalHostDisplay.mm
@@ -103,7 +103,7 @@ void MetalHostDisplay::DetachSurfaceOnMainThread()
 	m_layer = nullptr;
 }
 
-bool MetalHostDisplay::CreateDevice(const WindowInfo& wi)
+bool MetalHostDisplay::CreateDevice(const WindowInfo& wi, VsyncMode vsync)
 { @autoreleasepool {
 	m_window_info = wi;
 	pxAssertRel(!m_dev.dev, "Device already created!");
@@ -152,7 +152,7 @@ bool MetalHostDisplay::CreateDevice(const WindowInfo& wi)
 		{
 			AttachSurfaceOnMainThread();
 		});
-		SetVSync(Host::GetEffectiveVSyncMode());
+		SetVSync(vsync);
 		return true;
 	}
 	else
diff --git a/pcsx2/Frontend/OpenGLHostDisplay.cpp b/pcsx2/Frontend/OpenGLHostDisplay.cpp
index b6a332460d..31884ec531 100644
--- a/pcsx2/Frontend/OpenGLHostDisplay.cpp
+++ b/pcsx2/Frontend/OpenGLHostDisplay.cpp
@@ -143,7 +143,7 @@ void OpenGLHostDisplay::UpdateTexture(HostDisplayTexture* texture, u32 x, u32 y,
 
 void OpenGLHostDisplay::SetVSync(VsyncMode mode)
 {
-	if (m_gl_context->GetWindowInfo().type == WindowInfo::Type::Surfaceless)
+	if (m_vsync_mode == mode || m_gl_context->GetWindowInfo().type == WindowInfo::Type::Surfaceless)
 		return;
 
 	// Window framebuffer has to be bound to call SetSwapInterval.
@@ -155,6 +155,7 @@ void OpenGLHostDisplay::SetVSync(VsyncMode mode)
 		m_gl_context->SetSwapInterval(static_cast<s32>(mode != VsyncMode::Off));
 
 	glBindFramebuffer(GL_DRAW_FRAMEBUFFER, current_fbo);
+	m_vsync_mode = mode;
 }
 
 const char* OpenGLHostDisplay::GetGLSLVersionString() const
@@ -198,7 +199,7 @@ bool OpenGLHostDisplay::HasSurface() const
 	return m_window_info.type != WindowInfo::Type::Surfaceless;
 }
 
-bool OpenGLHostDisplay::CreateDevice(const WindowInfo& wi)
+bool OpenGLHostDisplay::CreateDevice(const WindowInfo& wi, VsyncMode vsync)
 {
 	m_gl_context = GL::Context::Create(wi);
 	if (!m_gl_context)
@@ -209,7 +210,7 @@ bool OpenGLHostDisplay::CreateDevice(const WindowInfo& wi)
 	}
 
 	m_window_info = m_gl_context->GetWindowInfo();
-	m_vsync_mode = Host::GetEffectiveVSyncMode();
+	m_vsync_mode = vsync;
 	return true;
 }
 
diff --git a/pcsx2/Frontend/OpenGLHostDisplay.h b/pcsx2/Frontend/OpenGLHostDisplay.h
index 345592e251..20469fe3e9 100644
--- a/pcsx2/Frontend/OpenGLHostDisplay.h
+++ b/pcsx2/Frontend/OpenGLHostDisplay.h
@@ -38,7 +38,7 @@ public:
 	bool HasDevice() const override;
 	bool HasSurface() const override;
 
-	bool CreateDevice(const WindowInfo& wi) override;
+	bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) override;
 	bool SetupDevice() override;
 
 	bool MakeCurrent() override;
diff --git a/pcsx2/Frontend/VulkanHostDisplay.cpp b/pcsx2/Frontend/VulkanHostDisplay.cpp
index f19de05657..52cec047cc 100644
--- a/pcsx2/Frontend/VulkanHostDisplay.cpp
+++ b/pcsx2/Frontend/VulkanHostDisplay.cpp
@@ -274,10 +274,9 @@ void VulkanHostDisplay::SetVSync(VsyncMode mode)
 	m_vsync_mode = mode;
 }
 
-bool VulkanHostDisplay::CreateDevice(const WindowInfo& wi)
+bool VulkanHostDisplay::CreateDevice(const WindowInfo& wi, VsyncMode vsync)
 {
 	WindowInfo local_wi(wi);
-	const VsyncMode vsync = Host::GetEffectiveVSyncMode();
 	const bool debug_device = EmuConfig.GS.UseDebugDevice;
 	if (!Vulkan::Context::Create(EmuConfig.GS.Adapter, &local_wi, &m_swap_chain, GetPreferredPresentModeForVsyncMode(vsync),
 			EmuConfig.GS.ThreadedPresentation, debug_device, debug_device))
diff --git a/pcsx2/Frontend/VulkanHostDisplay.h b/pcsx2/Frontend/VulkanHostDisplay.h
index f308cc1cbc..91d29c984b 100644
--- a/pcsx2/Frontend/VulkanHostDisplay.h
+++ b/pcsx2/Frontend/VulkanHostDisplay.h
@@ -27,7 +27,7 @@ public:
 	bool HasDevice() const override;
 	bool HasSurface() const override;
 
-	bool CreateDevice(const WindowInfo& wi) override;
+	bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) override;
 	bool SetupDevice() override;
 
 	bool MakeCurrent() override;
diff --git a/pcsx2/GS.cpp b/pcsx2/GS.cpp
index 5d5ee06ea7..7754b147d0 100644
--- a/pcsx2/GS.cpp
+++ b/pcsx2/GS.cpp
@@ -74,6 +74,10 @@ void gsUpdateFrequency(Pcsx2Config& config)
 		config.GS.LimitScalar = 0.0f;
 	}
 
+#ifdef PCSX2_CORE
+	GetMTGS().UpdateVSyncMode();
+#endif
+
 	UpdateVSyncRate();
 }
 
diff --git a/pcsx2/GS/GS.cpp b/pcsx2/GS/GS.cpp
index ed2e6331ae..d52a18079d 100644
--- a/pcsx2/GS/GS.cpp
+++ b/pcsx2/GS/GS.cpp
@@ -77,6 +77,7 @@ static HRESULT s_hr = E_FAIL;
 Pcsx2Config::GSOptions GSConfig;
 
 static RenderAPI s_render_api;
+static u64 s_next_manual_present_time;
 
 int GSinit()
 {
@@ -554,6 +555,33 @@ void GSPresentCurrentFrame()
 	g_gs_renderer->PresentCurrentFrame();
 }
 
+void GSThrottlePresentation()
+{
+	if (g_host_display->GetVsyncMode() != VsyncMode::Off)
+	{
+		// Let vsync take care of throttling.
+		return;
+	}
+
+	// Manually throttle presentation when vsync isn't enabled, so we don't try to render the
+	// fullscreen UI at thousands of FPS and make the gpu go brrrrrrrr.
+	const float surface_refresh_rate = g_host_display->GetWindowInfo().surface_refresh_rate;
+	const float throttle_rate = (surface_refresh_rate > 0.0f) ? surface_refresh_rate : 60.0f;
+
+	const u64 sleep_period = static_cast<u64>(static_cast<double>(GetTickFrequency()) / static_cast<double>(throttle_rate));
+	const u64 current_ts = GetCPUTicks();
+
+	// Allow it to fall behind/run ahead up to 2*period. Sleep isn't that precise, plus we need to
+	// allow time for the actual rendering.
+	const u64 max_variance = sleep_period * 2;
+	if (static_cast<u64>(std::abs(static_cast<s64>(current_ts - s_next_manual_present_time))) > max_variance)
+		s_next_manual_present_time = current_ts + sleep_period;
+	else
+		s_next_manual_present_time += sleep_period;
+
+	Threading::SleepUntil(s_next_manual_present_time);
+}
+
 #ifndef PCSX2_CORE
 
 void GSkeyEvent(const HostKeyEvent& e)
diff --git a/pcsx2/GS/GS.h b/pcsx2/GS/GS.h
index e17e39c1d4..338143a8ae 100644
--- a/pcsx2/GS/GS.h
+++ b/pcsx2/GS/GS.h
@@ -72,6 +72,7 @@ int GSfreeze(FreezeAction mode, freezeData* data);
 void GSQueueSnapshot(const std::string& path, u32 gsdump_frames = 0);
 void GSStopGSDump();
 void GSPresentCurrentFrame();
+void GSThrottlePresentation();
 #ifndef PCSX2_CORE
 void GSkeyEvent(const HostKeyEvent& e);
 void GSconfigure();
diff --git a/pcsx2/Host.h b/pcsx2/Host.h
index 0bd9df14bb..21cc8d05bd 100644
--- a/pcsx2/Host.h
+++ b/pcsx2/Host.h
@@ -24,6 +24,7 @@
 #include <optional>
 #include <vector>
 
+#ifndef PCSX2_CORE
 struct HostKeyEvent
 {
 	enum class Type
@@ -43,6 +44,7 @@ struct HostKeyEvent
 	Type type;
 	u32 key;
 };
+#endif
 
 namespace Host
 {
diff --git a/pcsx2/HostDisplay.cpp b/pcsx2/HostDisplay.cpp
index cdcb38e817..e208cac3fb 100644
--- a/pcsx2/HostDisplay.cpp
+++ b/pcsx2/HostDisplay.cpp
@@ -16,9 +16,15 @@
 #include "PrecompiledHeader.h"
 
 #include "HostDisplay.h"
+
+#ifdef PCSX2_CORE
+#include "VMManager.h"
+#endif
+
 #include "common/Assertions.h"
 #include "common/Console.h"
 #include "common/StringUtil.h"
+
 #include <cerrno>
 #include <cmath>
 #include <cstring>
@@ -128,6 +134,22 @@ std::string HostDisplay::GetFullscreenModeString(u32 width, u32 height, float re
 	return StringUtil::StdStringFromFormat("%u x %u @ %f hz", width, height, refresh_rate);
 }
 
+VsyncMode Host::GetEffectiveVSyncMode()
+{
+#ifdef PCSX2_CORE
+	const bool has_vm = VMManager::GetState() != VMState::Shutdown;
+#else
+	const bool has_vm = false;
+#endif
+
+	// Force vsync off when not running at 100% speed.
+	if (has_vm && EmuConfig.GS.LimitScalar != 1.0f)
+		return VsyncMode::Off;
+
+	// Otherwise use the config setting.
+	return EmuConfig.GS.VsyncEnable;
+}
+
 #ifdef ENABLE_OPENGL
 #include "Frontend/OpenGLHostDisplay.h"
 #endif
@@ -173,4 +195,3 @@ std::unique_ptr<HostDisplay> HostDisplay::CreateForAPI(RenderAPI api)
 			return {};
 	}
 }
-
diff --git a/pcsx2/HostDisplay.h b/pcsx2/HostDisplay.h
index eb10a24cd4..a3c6af85d1 100644
--- a/pcsx2/HostDisplay.h
+++ b/pcsx2/HostDisplay.h
@@ -84,6 +84,7 @@ public:
 	__fi s32 GetWindowWidth() const { return static_cast<s32>(m_window_info.surface_width); }
 	__fi s32 GetWindowHeight() const { return static_cast<s32>(m_window_info.surface_height); }
 	__fi float GetWindowScale() const { return m_window_info.surface_scale; }
+	__fi VsyncMode GetVsyncMode() const { return m_vsync_mode; }
 
 	/// Changes the alignment for this display (screen positioning).
 	__fi Alignment GetDisplayAlignment() const { return m_display_alignment; }
@@ -98,7 +99,7 @@ public:
 	virtual bool HasSurface() const = 0;
 
 	/// Creates the rendering/GPU device. This should be called on the thread which owns the window.
-	virtual bool CreateDevice(const WindowInfo& wi) = 0;
+	virtual bool CreateDevice(const WindowInfo& wi, VsyncMode vsync) = 0;
 
 	/// Fully initializes the rendering device. This should be called on the GS thread.
 	virtual bool SetupDevice() = 0;
diff --git a/pcsx2/MTGS.cpp b/pcsx2/MTGS.cpp
index 2587773aa9..3ed792d4b1 100644
--- a/pcsx2/MTGS.cpp
+++ b/pcsx2/MTGS.cpp
@@ -298,16 +298,14 @@ void SysMtgsThread::MainLoop()
 
 	while (true)
 	{
-
-		// Performance note: Both of these perform cancellation tests, but pthread_testcancel
-		// is very optimized (only 1 instruction test in most cases), so no point in trying
-		// to avoid it.
-
 #ifdef PCSX2_CORE
 		if (m_run_idle_flag.load(std::memory_order_acquire) && VMManager::GetState() != VMState::Running)
 		{
 			if (!m_sem_event.CheckForWork())
+			{
 				GSPresentCurrentFrame();
+				GSThrottlePresentation();
+			}
 		}
 		else
 		{
diff --git a/pcsx2/PAD/Gamepad.h b/pcsx2/PAD/Gamepad.h
index 9842794081..9e76575c6d 100644
--- a/pcsx2/PAD/Gamepad.h
+++ b/pcsx2/PAD/Gamepad.h
@@ -27,11 +27,16 @@ void PADclose();
 u8 PADstartPoll(int port, int slot);
 u8 PADpoll(u8 value);
 bool PADcomplete();
-HostKeyEvent* PADkeyEvent();
 void PADconfigure();
 s32 PADfreeze(FreezeAction mode, freezeData* data);
 s32 PADsetSlot(u8 port, u8 slot);
 
+#ifndef PCSX2_CORE
+
+HostKeyEvent* PADkeyEvent();
+
 #if defined(__unix__) || defined(__APPLE__)
 void PADWriteEvent(HostKeyEvent& evt);
 #endif
+
+#endif
\ No newline at end of file
diff --git a/pcsx2/VMManager.cpp b/pcsx2/VMManager.cpp
index 1200072aa1..3b1f55497d 100644
--- a/pcsx2/VMManager.cpp
+++ b/pcsx2/VMManager.cpp
@@ -1393,7 +1393,6 @@ void VMManager::SetLimiterMode(LimiterModeType type)
 
 	EmuConfig.LimiterMode = type;
 	gsUpdateFrequency(EmuConfig);
-	GetMTGS().UpdateVSyncMode();
 }
 
 void VMManager::FrameAdvance(u32 num_frames /*= 1*/)
@@ -1635,7 +1634,6 @@ void VMManager::CheckForFramerateConfigChanges(const Pcsx2Config& old_config)
 	gsUpdateFrequency(EmuConfig);
 	UpdateVSyncRate();
 	frameLimitReset();
-	GetMTGS().UpdateVSyncMode();
 }
 
 void VMManager::CheckForPatchConfigChanges(const Pcsx2Config& old_config)
diff --git a/pcsx2/gui/AppHost.cpp b/pcsx2/gui/AppHost.cpp
index 467a56a6dc..f82f0f4522 100644
--- a/pcsx2/gui/AppHost.cpp
+++ b/pcsx2/gui/AppHost.cpp
@@ -129,7 +129,8 @@ bool Host::AcquireHostDisplay(RenderAPI api, bool clear_state_on_fail)
 	if (!g_host_display)
 		return false;
 
-	if (!g_host_display->CreateDevice(g_gs_window_info) || !g_host_display->SetupDevice() || !ImGuiManager::Initialize())
+	if (!g_host_display->CreateDevice(g_gs_window_info, Host::GetEffectiveVSyncMode()) ||
+		!g_host_display->SetupDevice() || !ImGuiManager::Initialize())
 	{
 		g_host_display.reset();
 		return false;
@@ -151,16 +152,6 @@ void Host::ReleaseHostDisplay(bool clear_state_on_fail)
 	sApp.CloseGsPanel();
 }
 
-VsyncMode Host::GetEffectiveVSyncMode()
-{
-	// Force vsync off when not running at 100% speed.
-	if (EmuConfig.GS.LimitScalar != 1.0f)
-		return VsyncMode::Off;
-
-	// Otherwise use the config setting.
-	return EmuConfig.GS.VsyncEnable;
-}
-
 bool Host::BeginPresentFrame(bool frame_skip)
 {
 	CheckForGSWindowResize();