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Also you can cheese the hell out of Jack to conserve ammo.
Block his first attack, then crouch and knife his leg, while circling around him. Try to stay behind his back.
Hardest boss in the entire game is probably Mia in the guest house, rest is rather easy.
Just got to know that even getting caught as Mia in the tape is a true game over, which is kinda stupid if you ask me
And then I recommend at least one run with infinite ammo so you can have the catharsis of speedrunning the hardest mode like Kool-Aid man through a brick wall.
still the regular molded take way too many hits before going down
Something I wish I'd known my first time through is the game gives you plenty of cassette tapes. When you find out that saves are limited it's a little intimidating, but unless you were saving every time you mixed a first aid kit, you can probably save just as frequently on MH as you did on Normal. At the least you can afford to save every time you clear something you don't want to do twice.
Plus several saves for scavenge hunt for ammo and resources. Usually it is a good time to go through the house after the basement fight and the old house/greenhouse after killing Marguerite.
So, just avoid the bipedal ones and use enhanced handgun ammo to headshot the crawlers. Be very careful with crawlers since they have a leap attack that kills you instantly on madhouse since it does 1500+ damage (you can have only 1400 HP with all steroids).
Avoid the fat guys. The two one in the mines are the only actual nightmare on madhouse even for those who are good at it. You need a flame round from the grenade launcher to clear the ladder and pray that one neuro round will stun them long enough. The two ones in the early areas of the ship are on a strict patrol route, so only needs patience or diving through one of the side doors to make them despawn temporarily.
The barn fight is easy as long as you stock up on ammo and know how to unload all weapons at once and reload them while the second stumbles forward.
Essentially, if you have to fight, unload everything until it is dead, then use the respite to reload. The only base enemies you have to kill are the crawlers, maybe one molded in the basement, the ones you meet near the lift in the ship S2 level, and the ones in the final climbing gauntlet of the mines. All others can be avoided.
I know it's part of the game though, glad you're not killing everything like in 4-6