Question: Can you play Mah Jongg with six players?

Answer: Yes, the same rules apply as with four-handed Mah Jongg, The main difference is that you can choose to have one or two Bettors. If you use two Bettors, they would write their bets down on separate sheets of paper. It is important that the two Bettors not discuss their bet. At the end of the first game, the dice are rolled between the two extra players to see who will take East’s position at the table. Players then take turns rotating in the game.

Source: Mah Jongg Made Easy 2024,  SIX-HANDED MAH JONGG, page 28