For me: a touchpad as the primary pointer input device. I use two fingers for scrolling and a two-finger tap as middle mouse button clicks. I really like that setup for web browsing, but it frequently messes up code in the editor.
But I guess if middle-click never does anything useful for you (Windows, Mac), you might prioritise it less in your hardware design :|
Option "EmulateWheel" "on"
Option "EmulateWheelButton" "2"
Option "XAxisMapping" "6 7"
Option "YAxisMapping" "4 5"
Which is exactly the way I scroll: Hold the middle button and move the trackpoint.