MQA is nothing new. It's basically a new version of the failed HDCD. A 24bit 48kHz MQA-encoded FLAC file is essentially a 17bit/48KHz losses file plus 8 extra bits of lossy compression which contain the extra spectrum. When no MQA decoding is used during playback, then these 7 bits serve as high-frequency noise, which represents added dither noise. When MQA decoding is used during playback, then these 8 extra bits are used for the unfolding process, revealing the extra spectral data of the full 192kHz original master, which is then merged into the final audio stream.
Does it really work? According to many measurements and tests, not really. It does slightly extend the frequency response, but it is still, not the real deal of true 192kHz sampling.