On our downstream gtk-win32 project we are maintaining a patch for quite a while already to make it build with MSVC. It would be great if somebody could take the interesting parts from it and push it upstream: https://github.com/wingtk/gtk-win32/blob/master/fontconfig/fontconfig.patch
One concern before applying that patch, does it still work on MinGW? they also use WIN32 on ifdef lines.
All i can say is that mingw-w64 fontconfig-2.12.1 builds with this patch and passes all tests in the testsuite (all 4 of them...).
Though you should probably define FLEXIBLE_ARRAY_MEMBER to 1 (MSVC doesn't run the configure script, which detects this and defines this macro) instead of hardcoding 1 there.
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