I saw on Twitter that ArcadeTV has been working on some new MegaDrive+ patches. These MD+ patches add CD based audio support with the original ROM image. This means you can have high quality audio playing instead of the original music found on the cartridge. This does require compatible hardware such as a Terraonion MegaSD, Krikzz MEGA Everdrive PRO or MiSTer. You can also run it on the RetroArch core Genesis Plus GX.
Recently added games with MegaDrive+ support include Columns, Insector X, Marvel Land, Puyo Puyo and Super Fantasy Zone. You can find out more about the patches on the GitHub page here.