Tip overview

When using his ultimate, he does powerful melee attacks. Stay away from him then

Makoa's hook has a misleading left hitbox, so aiming slightly to the right will ensure a hook. Try moving to the left or keeping a wall to the right to make it harder for him to land a hook.

A good card to check when there is an enemy Makoa is Barrier Reef (Link to Barrier Reef image + desc: https://paladins.gamepedia.com/Barrier_Reef) if he is running it at Lv 4 or higher, ignore the shield so that he has to wait longer for his shield.

His ultimate ancient rage does not apply cauterize. Stay close to your healer to higher the chances to stay alive.

In case that Makoa is on low life and uses his shield, just step into the shield circle and serve the killing blow