It looks like QSound needs decoding of some sort to play correctly, last year MAME implemented correct QSound decoding, I was wondering whether any of these cores implement it in some way? There were some post-Genesis games the had QSound audio, check here: https://segaretro.org/QSound
I don’t know of any initiatives to use the updated qsound emulation. Picodrive probably wouldn’t be a good fit, being performance-focused but the others might.
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