I’d have to dig up the textbook sources, but the key bit is in the definition: market makers quote a two-sided market and make money from the spread [1], i.e. buying at the bid and selling at the offer. If it happens simultaneously, that’s ideal. Every second one is long or short, risk and cost are incurred. Market makers seek to minimise and manage these.
In practice, arbitrage is tough. So most market makers simulate simultaneity by hedging. For example, if longs are accumulating (e.g. due to specialist obligations) one might open shorts or buy positional puts or wing it by shorting SPYs.
An unhedged market maker is just day trading.
[1] https://www.investopedia.com/terms/m/marketmaker.asp#what-is...