As I mentioned last week, and I'm sure you've seen all over the audiophile news, TIDAL has started streaming MQA audio and has embedded a software decoder into the Windows/Mac desktop player. It will basically take a 24-bit 44kHz or 48kHz stream that's encoded by MQA and spit out an 88kHz or 96kHz data stream to send out to your DAC; whether the internal one in your laptop, or a fancy external DAC with options for "Exclusive" mode which allows changes to the appropriate samplerate (I know this works well on the PC, have not tried the Mac).
If you're not using "Exclusive" mode, you can tick "Force volume" to set it to 100% volume so the internal mixer/dither routine hopefully doesn't mess with it. "Passthrough MQA" should be ticked only if you have an MQA enabled DAC or want to purposely hear MQA undecoded (I'll say it now that this is not recommended). My assumption is that if you do have one of these MQA DACs and passthrough is on, you should either make sure "Exclusive" mode is ticked or if not, manually make sure the OS samplerate is correct (ie. 44kHz or 48kHz at 24-bit depth) and that the volume is 100% (either with "Force volume" or making sure the computer volume slider is 100%). Otherwise, it will not be "bit-perfect" and the DAC will not recognize the MQA encoding. I suspect this could be confusing for some.