diff --git a/src/plugins/platforms/cocoa/qcocoamessagedialog.mm b/src/plugins/platforms/cocoa/qcocoamessagedialog.mm
index 82a4c90c236..993e645a67e 100644
--- a/src/plugins/platforms/cocoa/qcocoamessagedialog.mm
+++ b/src/plugins/platforms/cocoa/qcocoamessagedialog.mm
@@ -151,6 +151,8 @@ bool QCocoaMessageDialog::show(Qt::WindowFlags windowFlags, Qt::WindowModality w
         // button). If an explicit default or escape button has been set, we respect these,
         // and otherwise we fall back to role-based default and escape buttons.
 
+        qCDebug(lcQpaDialogs).verbosity(0) << "Adding button" << title << "with" << role;
+
         if (!defaultButton && role == AcceptRole)
             defaultButton = tag;
 
@@ -186,19 +188,63 @@ bool QCocoaMessageDialog::show(Qt::WindowFlags windowFlags, Qt::WindowModality w
         button.tag = tag;
     };
 
+    // Resolve all dialog buttons from the options, both standard and custom
+
+    struct Button { QString title; int identifier; ButtonRole role; };
+    std::vector<Button> buttons;
+
     const auto *platformTheme = QGuiApplicationPrivate::platformTheme();
     if (auto standardButtons = options()->standardButtons()) {
         for (int standardButton = FirstButton; standardButton <= LastButton; standardButton <<= 1) {
             if (standardButtons & standardButton) {
                 auto title = platformTheme->standardButtonText(standardButton);
-                addButton(title, standardButton, buttonRole(StandardButton(standardButton)));
+                buttons.push_back({
+                    title, standardButton, buttonRole(StandardButton(standardButton))
+                });
             }
         }
     }
-
     const auto customButtons = options()->customButtons();
     for (auto customButton : customButtons)
-        addButton(customButton.label, customButton.id, customButton.role);
+        buttons.push_back({customButton.label, customButton.id, customButton.role});
+
+    // Sort them according to the QPlatformDialogHelper::ButtonLayout for macOS
+
+    // The ButtonLayout adds one additional role, AlternateRole, which is used
+    // for any AcceptRole beyond the first one, and should be ordered before the
+    // AcceptRole. Set this up by fixing the roles up front.
+    bool seenAccept = false;
+    for (auto &button : buttons) {
+        if (button.role == AcceptRole) {
+            if (!seenAccept)
+                seenAccept = true;
+            else
+                button.role = AlternateRole;
+        }
+    }
+
+    std::vector<Button> orderedButtons;
+    const int *layoutEntry = buttonLayout(Qt::Horizontal, ButtonLayout::MacLayout);
+    while (*layoutEntry != QPlatformDialogHelper::EOL) {
+        const auto role = ButtonRole(*layoutEntry & ~ButtonRole::Reverse);
+        const bool reverse = *layoutEntry & ButtonRole::Reverse;
+
+        auto addButton = [&](const Button &button) {
+            if (button.role == role)
+                orderedButtons.push_back(button);
+        };
+
+        if (reverse)
+            std::for_each(std::crbegin(buttons), std::crend(buttons), addButton);
+        else
+            std::for_each(std::cbegin(buttons), std::cend(buttons), addButton);
+
+        ++layoutEntry;
+    }
+
+    // Add them to the alert in reverse order, since buttons are added right to left
+    for (auto button = orderedButtons.crbegin(); button != orderedButtons.crend(); ++button)
+        addButton(button->title, button->identifier, button->role);
 
     // If we didn't find a an explicit or implicit default button above
     // we restore the AppKit behavior of making the first button default.