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Tomb of the Ancients has mostly existed in the background throughout its initial release in Season 3. While it reads quite well on the surface, it just couldn't keep up with the ever-present one-shot builds.
Now that many builds have been toned down, Tomb of the Ancients is able to step into the spotlight. It offers a solid combination of damage-over-time, recovery, and lockdown; perfect for longer fights.
Quest items have become a key part of Mak's identity, offering players a reward for proper pathing and a well-managed Economy. As a Large item, Tomb of the Ancients is actually very accessible with its base Silver-tier. However, its power won't truly unlock until you've completed additional Quests.
As for which Quest items you should fulfill, that's ultimately up to you. However, just keep in mind not to spread yourself too thin. It's often best to choose one focus at a time in order to be able to afford enough items.
A helpful Economy tip is to utilize 
Peacewrought plus a 
Catalyst generator (
Aludel, 
Mortar & Pestle, etc.) or two. This allows you to passively farm gold quite easily, while also getting more gold out of your items. Just make sure you upgrade Peacewrought to at least Silver-tier as soon as you can.
Blank Slate is the one Quest item you'll always want to pickup, as unlike the others, purchasing items isn't required. It's important to find it earlier than later as it gives you more time to unlock its many Quest conditions.
During the early game, try to utilize Small items with dual properties such as 
Thurible and 
Venomander. While these are generally underwhelming, they do a great job at filling the board early while contributing to Blank Slate.
Kripp enchanted the Blank Slate with Obsidian to give it some more offensive power. It's a solid choice, but not mandatory as there are plenty of great alternatives.
Frost Totem is underwhelming on its own but quickly becomes useful once a 
Sapphire or two are available. Since Freeze items can be hard to come by, it's best to grab Frost Totem early if you see it, even alongside another Quest item. You'll only need to purchase three extras, which is a lot more manageable.
In general, Freeze items work best in multiples, so if you don't have a good baseline established, just Stash Frost Totem in the meantime. The only thing to keep in mind is space, as if you're working towards various Quest items at a time alongside a Peacewrought Econ setup, things get tight quick.
Kripp's Fiery enchanted Frost Totem specifically paired well with his scaling Burn skills. Otherwise, you're likely better off with a defensive or utility enchant.
Sapphire is an obvious inclusion to any Freeze build and it fits right at home with Tomb of the Ancients. Being able to increase the Freeze duration while also fulfilling the Relic tag for its Multicast is win-win. Without Sapphire, Freeze is far less reliable, in which case you should lean into an alternative setup.
Weaselpede is an underrated Freeze item that happens to work incredibly well with Tomb of the Ancients. Since Poison is required for its Multicast, it's the perfect fit to take advantage of its very impactful disruption.
While it's a bit weak at Silver-tier, upgrading it to Gold/Diamond increases its Freeze duration by one second per tier. This makes Weaselpede have one of the longest Freeze durations in the game, and with a moderate six second Cooldown + Multicast, it's the real deal. Overall a solid alternative to one of the Quest items, but it doesn't change the fact you still need to complete quests for Tomb of the Ancients.
Quicksilver is the most reliable way to get a second Sapphire. If you happen to get one naturally via Transforms or other means, great. Though if you don't, this is a pretty easy alternative.
One thing to keep in mind is that you specifically want a Silver-tier Quicksilver, nothing higher. Alongside this particular setup it guarantees you get Sapphire every time. When an item only exists at Gold or Diamond, it can't Transform into a Silver copy of it, so stick with Silver to avoid the gamble.
Pendulum is a Mak staple for its incredible Charging capabilities. While generally not accessible until later on, it's a welcome inclusion for the late game to help give you a huge edge in speed. Though do keep in mind, you'll definitely want to upgrade it to Diamond for its increased Charge rate.
Wand fulfills a slightly similar role, but instead focuses on supporting the board rather than turbo-spamming two items. While not an normal pickup for Mak, you may come across it when visiting specialty vendors.
Vitality Potion is incredibly useful in slower damage-over-time builds. When timed well it acts as an emergency button, plus can Cleanse a massive amount of enemy Burn/Poison. Additionally, it's a fantastic target for enchantments since the scaling matches so well.
Kripp had a Shielded Vitality Potion, making it an exceptional line of defense while Tomb of the Ancients and Blank Slate build up.
Reaching the Summit is often niche in its usage, but given the number of individual Freezes from Tomb of the Ancients it's an excellent choice. This build is a little weaker in terms of offense, so having a way to reliably scale up to 100 is a big improvement in longer fights.
Conflagration and 
Purifying Flame both give the build a lot more scaling power, beyond just normally stacking Burn/Poison. While you can certainly go the distance without additional scaling, it definitely helps to pack more power in case your Freeze isn't enough to halt the enemy.
Unwavering is a great defensive skill that gives Mak some reliable Shield stacking. It's definitely not a common skill as a monster drop, but do be on the lookout for anything that can give you a bit of extra padding. As strong as Regen can be, it won't help if the opponent scales to eventually 100-0 you.
