Like you said they get paid if it goes up or down. They have no reason to drive the price down. I think you are confusing MM manipulation with CD Holders "toxic lenders". They are the true manipulators in OTC.
MM's do not trade these pennies on their own, only under the direction of someone placing an order. If they want to trade the stock themselves, either long or short, they have to do so in a proprietary account separate from their market making activities.
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