diff --git a/src/core/fullscreen_ui.cpp b/src/core/fullscreen_ui.cpp
index dd621e20e..8f055d01e 100644
--- a/src/core/fullscreen_ui.cpp
+++ b/src/core/fullscreen_ui.cpp
@@ -3803,6 +3803,11 @@ void FullscreenUI::DrawControllerSettingsPage()
       DrawInputBindingButton(bsi, InputBindingInfo::Type::Macro, section.c_str(),
                              TinyString::from_format("Macro{}", macro_index + 1),
                              TinyString::from_format(FSUI_FSTR("Macro {} Trigger"), macro_index + 1), nullptr);
+      DrawToggleSetting(bsi,
+                        TinyString::from_format(fmt::runtime(FSUI_ICONSTR(ICON_FA_GAMEPAD, "Macro {} Press To Toggle")),
+                                                macro_index + 1),
+                        nullptr, section.c_str(), TinyString::from_format("Macro{}Toggle", macro_index + 1), false,
+                        true, false, LAYOUT_MENU_BUTTON_HEIGHT_NO_SUMMARY);
 
       SmallString binds_string =
         bsi->GetSmallStringValue(section.c_str(), fmt::format("Macro{}Binds", macro_index + 1).c_str());
diff --git a/src/duckstation-qt/controllerbindingwidgets.cpp b/src/duckstation-qt/controllerbindingwidgets.cpp
index 08db8f0e8..4b9283357 100644
--- a/src/duckstation-qt/controllerbindingwidgets.cpp
+++ b/src/duckstation-qt/controllerbindingwidgets.cpp
@@ -569,7 +569,7 @@ ControllerMacroEditWidget::ControllerMacroEditWidget(ControllerMacroWidget* pare
 
   // load binds (single string joined by &)
   const std::string binds_string(
-    dialog->getStringValue(section.c_str(), fmt::format("Macro{}Binds", index + 1u).c_str(), ""));
+    dialog->getStringValue(section.c_str(), TinyString::from_format("Macro{}Binds", index + 1u), ""));
   const std::vector<std::string_view> buttons_split(StringUtil::SplitString(binds_string, '&', true));
 
   for (const std::string_view& button : buttons_split)
@@ -597,7 +597,10 @@ ControllerMacroEditWidget::ControllerMacroEditWidget(ControllerMacroWidget* pare
     m_ui.bindList->addItem(item);
   }
 
-  m_frequency = dialog->getIntValue(section.c_str(), fmt::format("Macro{}Frequency", index + 1u).c_str(), 0);
+  m_frequency = dialog->getIntValue(section.c_str(), TinyString::from_format("Macro{}Frequency", index + 1u), 0);
+  ControllerSettingWidgetBinder::BindWidgetToInputProfileBool(dialog->getProfileSettingsInterface(), m_ui.triggerToggle,
+                                                              section.c_str(), fmt::format("Macro{}Toggle", index + 1u),
+                                                              false);
   updateFrequencyText();
 
   m_ui.trigger->initialize(dialog->getProfileSettingsInterface(), InputBindingInfo::Type::Macro, section,
diff --git a/src/duckstation-qt/controllermacroeditwidget.ui b/src/duckstation-qt/controllermacroeditwidget.ui
index 33cde4ed3..d4f051c2e 100644
--- a/src/duckstation-qt/controllermacroeditwidget.ui
+++ b/src/duckstation-qt/controllermacroeditwidget.ui
@@ -6,11 +6,11 @@
    <rect>
     <x>0</x>
     <y>0</y>
-    <width>595</width>
-    <height>473</height>
+    <width>664</width>
+    <height>420</height>
    </rect>
   </property>
-  <layout class="QVBoxLayout" name="verticalLayout">
+  <layout class="QVBoxLayout" name="verticalLayout" stretch="1,0,0">
    <property name="leftMargin">
     <number>0</number>
    </property>
@@ -51,20 +51,31 @@
       <string>Trigger</string>
      </property>
      <layout class="QGridLayout" name="gridLayout">
-      <item row="0" column="0" colspan="2">
-       <widget class="QLabel" name="label">
-        <property name="text">
-         <string>Select the trigger to activate this macro. This can be a single button, or combination of buttons (chord). Shift-click for multiple triggers.</string>
-        </property>
-        <property name="alignment">
-         <set>Qt::AlignLeading|Qt::AlignLeft|Qt::AlignTop</set>
-        </property>
-        <property name="wordWrap">
-         <bool>true</bool>
-        </property>
-       </widget>
+      <item row="0" column="0">
+       <layout class="QHBoxLayout" name="horizontalLayout_5" stretch="1,0">
+        <item>
+         <widget class="QLabel" name="label_5">
+          <property name="text">
+           <string>Select the trigger to activate this macro. This can be a single button, or combination of buttons (chord). Shift-click for multiple triggers.</string>
+          </property>
+          <property name="alignment">
+           <set>Qt::AlignLeading|Qt::AlignLeft|Qt::AlignTop</set>
+          </property>
+          <property name="wordWrap">
+           <bool>true</bool>
+          </property>
+         </widget>
+        </item>
+        <item>
+         <widget class="QCheckBox" name="triggerToggle">
+          <property name="text">
+           <string>Press To Toggle</string>
+          </property>
+         </widget>
+        </item>
+       </layout>
       </item>
-      <item row="1" column="0" colspan="2">
+      <item row="1" column="0">
        <widget class="InputBindingWidget" name="trigger">
         <property name="text">
          <string>PushButton</string>
@@ -127,19 +138,6 @@
      </layout>
     </widget>
    </item>
-   <item>
-    <spacer name="verticalSpacer">
-     <property name="orientation">
-      <enum>Qt::Vertical</enum>
-     </property>
-     <property name="sizeHint" stdset="0">
-      <size>
-       <width>20</width>
-       <height>40</height>
-      </size>
-     </property>
-    </spacer>
-   </item>
   </layout>
  </widget>
  <customwidgets>
diff --git a/src/util/imgui_fullscreen.cpp b/src/util/imgui_fullscreen.cpp
index df82a8014..7fe712a64 100644
--- a/src/util/imgui_fullscreen.cpp
+++ b/src/util/imgui_fullscreen.cpp
@@ -1358,7 +1358,7 @@ bool ImGuiFullscreen::ToggleButton(const char* title, const char* summary, bool*
   const float toggle_width = LayoutScale(50.0f);
   const float toggle_height = LayoutScale(25.0f);
   const float toggle_x = LayoutScale(8.0f);
-  const float toggle_y = (LayoutScale(LAYOUT_MENU_BUTTON_HEIGHT) - toggle_height) * 0.5f;
+  const float toggle_y = (LayoutScale(height) - toggle_height) * 0.5f;
   const float toggle_radius = toggle_height * 0.5f;
   const ImVec2 toggle_pos(bb.Max.x - toggle_width - toggle_x, bb.Min.y + toggle_y);
 
diff --git a/src/util/input_manager.cpp b/src/util/input_manager.cpp
index 39aa528c8..df99c1825 100644
--- a/src/util/input_manager.cpp
+++ b/src/util/input_manager.cpp
@@ -86,10 +86,11 @@ struct PadVibrationBinding
 struct MacroButton
 {
   std::vector<u32> buttons; ///< Buttons to activate.
-  u32 toggle_frequency;     ///< Interval at which the buttons will be toggled, if not 0.
-  u32 toggle_counter;       ///< When this counter reaches zero, buttons will be toggled.
+  u16 toggle_frequency;     ///< Interval at which the buttons will be toggled, if not 0.
+  u16 toggle_counter;       ///< When this counter reaches zero, buttons will be toggled.
   bool toggle_state;        ///< Current state for turbo.
   bool trigger_state;       ///< Whether the macro button is active.
+  bool trigger_toggle;      ///< Whether the macro is trigged by holding or press.
 };
 
 } // namespace
@@ -1578,10 +1579,13 @@ void InputManager::LoadMacroButtonConfig(SettingsInterface& si, const std::strin
   for (u32 i = 0; i < NUM_MACRO_BUTTONS_PER_CONTROLLER; i++)
   {
     std::string binds_string;
-    if (!si.GetStringValue(section.c_str(), fmt::format("Macro{}Binds", i + 1u).c_str(), &binds_string))
+    if (!si.GetStringValue(section.c_str(), TinyString::from_format("Macro{}Binds", i + 1u), &binds_string))
       continue;
 
-    const u32 frequency = si.GetUIntValue(section.c_str(), fmt::format("Macro{}Frequency", i + 1u).c_str(), 0u);
+    const u32 frequency =
+      std::min<u32>(si.GetUIntValue(section.c_str(), TinyString::from_format("Macro{}Frequency", i + 1u), 0u),
+                    std::numeric_limits<u16>::max());
+    const bool toggle = si.GetBoolValue(section.c_str(), TinyString::from_format("Macro{}Toggle", i + 1u), false);
 
     // convert binds
     std::vector<u32> bind_indices;
@@ -1612,7 +1616,8 @@ void InputManager::LoadMacroButtonConfig(SettingsInterface& si, const std::strin
       continue;
 
     s_macro_buttons[pad][i].buttons = std::move(bind_indices);
-    s_macro_buttons[pad][i].toggle_frequency = frequency;
+    s_macro_buttons[pad][i].toggle_frequency = static_cast<u16>(frequency);
+    s_macro_buttons[pad][i].trigger_toggle = toggle;
   }
 }
 
@@ -1622,14 +1627,18 @@ void InputManager::SetMacroButtonState(u32 pad, u32 index, bool state)
     return;
 
   MacroButton& mb = s_macro_buttons[pad][index];
-  if (mb.buttons.empty() || mb.trigger_state == state)
+  if (mb.buttons.empty())
+    return;
+
+  const bool trigger_state = (mb.trigger_toggle ? (state ? !mb.trigger_state : mb.trigger_state) : state);
+  if (mb.trigger_state == trigger_state)
     return;
 
   mb.toggle_counter = mb.toggle_frequency;
-  mb.trigger_state = state;
-  if (mb.toggle_state != state)
+  mb.trigger_state = trigger_state;
+  if (mb.toggle_state != trigger_state)
   {
-    mb.toggle_state = state;
+    mb.toggle_state = trigger_state;
     ApplyMacroButton(pad, mb);
   }
 }