diff --git a/rpcs3/Emu/Io/RB3MidiDrums.cpp b/rpcs3/Emu/Io/RB3MidiDrums.cpp
index 61b172bbdd..4bdc253c69 100644
--- a/rpcs3/Emu/Io/RB3MidiDrums.cpp
+++ b/rpcs3/Emu/Io/RB3MidiDrums.cpp
@@ -412,7 +412,10 @@ usb_device_rb3_midi_drums::usb_device_rb3_midi_drums(const std::array<u8, 7>& lo
 
 usb_device_rb3_midi_drums::~usb_device_rb3_midi_drums()
 {
-	rtmidi_in_free(midi_in);
+	if (midi_in)
+	{
+		rtmidi_in_free(midi_in);
+	}
 }
 
 static const std::array<u8, 40> disabled_response = {
diff --git a/rpcs3/Emu/Io/RB3MidiGuitar.cpp b/rpcs3/Emu/Io/RB3MidiGuitar.cpp
index 1d6d10bb76..923fc3a98b 100644
--- a/rpcs3/Emu/Io/RB3MidiGuitar.cpp
+++ b/rpcs3/Emu/Io/RB3MidiGuitar.cpp
@@ -100,7 +100,10 @@ usb_device_rb3_midi_guitar::usb_device_rb3_midi_guitar(const std::array<u8, 7>&
 
 usb_device_rb3_midi_guitar::~usb_device_rb3_midi_guitar()
 {
-	rtmidi_in_free(midi_in);
+	if (midi_in)
+	{
+		rtmidi_in_free(midi_in);
+	}
 }
 
 static const std::array<u8, 40> disabled_response = {
diff --git a/rpcs3/Emu/Io/RB3MidiKeyboard.cpp b/rpcs3/Emu/Io/RB3MidiKeyboard.cpp
index ccfc2dbdc8..f96f138628 100644
--- a/rpcs3/Emu/Io/RB3MidiKeyboard.cpp
+++ b/rpcs3/Emu/Io/RB3MidiKeyboard.cpp
@@ -86,7 +86,10 @@ usb_device_rb3_midi_keyboard::usb_device_rb3_midi_keyboard(const std::array<u8,
 
 usb_device_rb3_midi_keyboard::~usb_device_rb3_midi_keyboard()
 {
-	rtmidi_in_free(midi_in);
+	if (midi_in)
+	{
+		rtmidi_in_free(midi_in);
+	}
 }
 
 static const std::array<u8, 40> disabled_response = {
diff --git a/rpcs3/rpcs3qt/config_checker.cpp b/rpcs3/rpcs3qt/config_checker.cpp
index f8ff600205..9833959ced 100644
--- a/rpcs3/rpcs3qt/config_checker.cpp
+++ b/rpcs3/rpcs3qt/config_checker.cpp
@@ -302,7 +302,7 @@ bool config_checker::check_config(cfg_mode mode, QString content_or_serial, QStr
 					const std::array<midi_device, max_midi_devices> def_devices = mc.get_selection_list();
 
 					mc.parse_devices(val);
-					const std::array<midi_device, max_midi_devices> devices = mc.get_selection_list();
+					const std::array<midi_device, max_midi_devices>& devices = mc.get_selection_list();
 
 					for (usz i = 0; i < devices.size(); i++)
 					{
@@ -327,7 +327,7 @@ bool config_checker::check_config(cfg_mode mode, QString content_or_serial, QStr
 					const std::array<std::string, 4> def_devices = mc.get_selection_list();
 
 					mc.parse_devices(val);
-					const std::array<std::string, 4> devices = mc.get_selection_list();
+					const std::array<std::string, 4>& devices = mc.get_selection_list();
 
 					for (usz i = 0; i < devices.size(); i++)
 					{
diff --git a/rpcs3/rpcs3qt/microphone_creator.cpp b/rpcs3/rpcs3qt/microphone_creator.cpp
index c44449c544..7b9a0d6829 100644
--- a/rpcs3/rpcs3qt/microphone_creator.cpp
+++ b/rpcs3/rpcs3qt/microphone_creator.cpp
@@ -14,7 +14,7 @@ microphone_creator::microphone_creator()
 }
 
 // We need to recreate the localized string because the microphone creator is currently only created once.
-QString microphone_creator::get_none()
+QString microphone_creator::get_none() const
 {
 	return tr("None", "Microphone device");
 }
@@ -49,12 +49,12 @@ void microphone_creator::refresh_list()
 	}
 }
 
-QStringList microphone_creator::get_microphone_list() const
+const QStringList& microphone_creator::get_microphone_list() const
 {
 	return m_microphone_list;
 }
 
-std::array<std::string, 4> microphone_creator::get_selection_list() const
+const std::array<std::string, 4>& microphone_creator::get_selection_list() const
 {
 	return m_sel_list;
 }
diff --git a/rpcs3/rpcs3qt/microphone_creator.h b/rpcs3/rpcs3qt/microphone_creator.h
index 37b2672083..2a1c71ddd1 100644
--- a/rpcs3/rpcs3qt/microphone_creator.h
+++ b/rpcs3/rpcs3qt/microphone_creator.h
@@ -15,12 +15,12 @@ class microphone_creator : public QObject
 
 public:
 	microphone_creator();
-	QString get_none();
+	QString get_none() const;
 	std::string set_device(u32 num, const QString& text);
 	void parse_devices(std::string_view list);
 	void refresh_list();
-	QStringList get_microphone_list() const;
-	std::array<std::string, 4> get_selection_list() const;
+	const QStringList& get_microphone_list() const;
+	const std::array<std::string, 4>& get_selection_list() const;
 
 private:
 	QStringList m_microphone_list;
diff --git a/rpcs3/rpcs3qt/midi_creator.cpp b/rpcs3/rpcs3qt/midi_creator.cpp
index d4ad70d5e9..587b1a04eb 100644
--- a/rpcs3/rpcs3qt/midi_creator.cpp
+++ b/rpcs3/rpcs3qt/midi_creator.cpp
@@ -8,24 +8,57 @@
 
 LOG_CHANNEL(cfg_log, "CFG");
 
+const auto midi_deleter = [](RtMidiWrapper* ptr) { if (ptr) rtmidi_in_free(ptr); };
+using midi_ptr = std::unique_ptr<RtMidiWrapper, decltype(midi_deleter)>;
+
+std::mutex midi_creator::m_midi_init_mutex = {};
+std::unique_ptr<std::thread> midi_creator::m_midi_init_thread = {};
+
 midi_creator::midi_creator()
 {
 	setObjectName("midi_creator");
+
+	// Initialize rtmidi async. This can take 10+ seconds on a cold start.
+	std::lock_guard lock(m_midi_init_mutex);
+	if (!m_midi_init_thread)
+	{
+		m_midi_init_thread = std::make_unique<std::thread>([]
+		{
+			[[maybe_unused]] midi_ptr midi_in(rtmidi_in_create_default());
+		});
+	}
+}
+
+midi_creator::~midi_creator()
+{
+	std::lock_guard lock(m_midi_init_mutex);
+	if (m_midi_init_thread && m_midi_init_thread->joinable())
+	{
+		m_midi_init_thread->join();
+	}
 }
 
 // We need to recreate the localized string because the midi creator is currently only created once.
-QString midi_creator::get_none()
+QString midi_creator::get_none() const
 {
 	return tr("None", "MIDI device");
 }
 
 void midi_creator::refresh_list()
 {
+	// Wait for initial initialization
+	{
+		std::lock_guard lock(m_midi_init_mutex);
+		if (m_midi_init_thread && m_midi_init_thread->joinable())
+		{
+			m_midi_init_thread->join();
+		}
+	}
+
 	m_midi_list.clear();
 	m_midi_list.append(get_none());
 
-	const auto deleter = [](RtMidiWrapper* ptr) { if (ptr) rtmidi_in_free(ptr); };
-	std::unique_ptr<RtMidiWrapper, decltype(deleter)> midi_in(rtmidi_in_create_default());
+	midi_ptr midi_in(rtmidi_in_create_default());
 	ensure(midi_in);
 
 	if (!midi_in->ok)
@@ -74,12 +107,12 @@ void midi_creator::refresh_list()
 	}
 }
 
-QStringList midi_creator::get_midi_list() const
+const QStringList& midi_creator::get_midi_list() const
 {
 	return m_midi_list;
 }
 
-std::array<midi_device, max_midi_devices> midi_creator::get_selection_list() const
+const std::array<midi_device, max_midi_devices>& midi_creator::get_selection_list() const
 {
 	return m_sel_list;
 }
diff --git a/rpcs3/rpcs3qt/midi_creator.h b/rpcs3/rpcs3qt/midi_creator.h
index 5a8cb05fd6..3aefcb8a7d 100644
--- a/rpcs3/rpcs3qt/midi_creator.h
+++ b/rpcs3/rpcs3qt/midi_creator.h
@@ -3,6 +3,9 @@
 #include "util/types.hpp"
 #include "Emu/Io/midi_config_types.h"
 
+#include <mutex>
+#include <thread>
+
 #include <QObject>
 #include <QStringList>
 
@@ -12,14 +15,18 @@ class midi_creator : public QObject
 
 public:
 	midi_creator();
-	QString get_none();
+	virtual ~midi_creator();
+
+	QString get_none() const;
 	std::string set_device(u32 num, const midi_device& device);
 	void parse_devices(std::string_view list);
 	void refresh_list();
-	QStringList get_midi_list() const;
-	std::array<midi_device, max_midi_devices> get_selection_list() const;
+	const QStringList& get_midi_list() const;
+	const std::array<midi_device, max_midi_devices>& get_selection_list() const;
 
 private:
+	static std::mutex m_midi_init_mutex;
+	static std::unique_ptr<std::thread> m_midi_init_thread;
 	QStringList m_midi_list;
 	std::array<midi_device, max_midi_devices> m_sel_list;
 };
diff --git a/rpcs3/rpcs3qt/settings_dialog.cpp b/rpcs3/rpcs3qt/settings_dialog.cpp
index ce791f18c5..c84cdc53c6 100644
--- a/rpcs3/rpcs3qt/settings_dialog.cpp
+++ b/rpcs3/rpcs3qt/settings_dialog.cpp
@@ -933,8 +933,11 @@ settings_dialog::settings_dialog(std::shared_ptr<gui_settings> gui_settings, std
 			QStringList cur_list = m_emu_settings->m_microphone_creator.get_microphone_list();
 			for (u32 subindex = 0; subindex < m_mics_combo.size(); subindex++)
 			{
-				if (subindex != index && m_mics_combo[subindex]->currentText() != mic_none)
-					cur_list.removeOne(m_mics_combo[subindex]->currentText());
+				if (subindex == index) continue;
+				if (const QString text = m_mics_combo[subindex]->currentText(); text != mic_none)
+				{
+					cur_list.removeOne(text);
+				}
 			}
 			m_mics_combo[index]->blockSignals(true);
 			m_mics_combo[index]->clear();
@@ -949,7 +952,9 @@ settings_dialog::settings_dialog(std::shared_ptr<gui_settings> gui_settings, std
 	{
 		m_emu_settings->SetSetting(emu_settings_type::MicrophoneDevices, m_emu_settings->m_microphone_creator.set_device(index, text));
 		if (const u32 next_index = index + 1; next_index < m_mics_combo.size() && text == mic_none)
+		{
 			m_mics_combo[next_index]->setCurrentText(mic_none);
+		}
 		propagate_used_devices();
 	};
 
@@ -1102,7 +1107,7 @@ settings_dialog::settings_dialog(std::shared_ptr<gui_settings> gui_settings, std
 
 	m_emu_settings->m_microphone_creator.parse_devices(m_emu_settings->GetSetting(emu_settings_type::MicrophoneDevices));
 
-	const std::array<std::string, 4> mic_sel_list = m_emu_settings->m_microphone_creator.get_selection_list();
+	const std::array<std::string, 4>& mic_sel_list = m_emu_settings->m_microphone_creator.get_selection_list();
 
 	for (s32 index = static_cast<int>(mic_sel_list.size()) - 1; index >= 0; index--)
 	{
@@ -1276,8 +1281,11 @@ settings_dialog::settings_dialog(std::shared_ptr<gui_settings> gui_settings, std
 			QStringList cur_list = m_emu_settings->m_midi_creator.get_midi_list();
 			for (u32 subindex = 0; subindex < m_midi_device_combo.size(); subindex++)
 			{
-				if (subindex != index && m_midi_device_combo[subindex]->currentText() != midi_none)
-					cur_list.removeOne(m_midi_device_combo[subindex]->currentText());
+				if (subindex == index) continue;
+				if (const QString text = m_midi_device_combo[subindex]->currentText(); text != midi_none)
+				{
+					cur_list.removeOne(text);
+				}
 			}
 			m_midi_device_combo[index]->blockSignals(true);
 			m_midi_device_combo[index]->clear();
@@ -1326,7 +1334,7 @@ settings_dialog::settings_dialog(std::shared_ptr<gui_settings> gui_settings, std
 
 	m_emu_settings->m_midi_creator.parse_devices(m_emu_settings->GetSetting(emu_settings_type::MidiDevices));
 
-	const std::array<midi_device, max_midi_devices> midi_sel_list = m_emu_settings->m_midi_creator.get_selection_list();
+	const std::array<midi_device, max_midi_devices>& midi_sel_list = m_emu_settings->m_midi_creator.get_selection_list();
 
 	for (s32 index = static_cast<int>(midi_sel_list.size()) - 1; index >= 0; index--)
 	{