I wonder since AndroidX Paging now is a mutiplatform project with macOS support, I wonder can we get macOS support in sqldelight-androidx-paging3?

No reason why not! Also, cause the SQLDelight extension is built against Multiplatform Paging, we should be able to support all targets listed at https://github.com/cashapp/multiplatform-paging/blob/1b4efd3eccf34b8cff596f530273bb988f34c659/paging-common/build.gradle.kts#L50-L67