Aligned on it, for Medchal they should extend pf 4/5 to 24 coacher so that it can hold 2 MMTS trains on one platform easily. Plus need to add 2-3 stabling lines.
Malkajgiri pf 1/2 is quite wide, they can trim it off and lay an additional track while the 4th platform can easily be formed at the second entry (some shops they will have to remove though for road widening and circulating area).
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Trains like LTT-SC Duronto can be extended till Medchal with additional stops at Malkajgiri and Lingampalli to deboard the folks living in western suburb and near Army Cantonment side.