What it does
Madness lets you cast a card for an alternative cost when you discard it, rather than putting it into your graveyard. When you discard a card with madness (from any effect, including discarding to hand size), you exile it instead. You then get the option to cast it by paying its madness cost. If you don't, it goes to the graveyard.
The big nuance people miss: discarding to madness still counts as discarding, so it triggers "whenever you discard" effects. Also, casting via madness happens during the resolution of the discard, so you cast it even if you have no priority window—and it uses the stack normally. If you decline or can't pay, the card heads to the graveyard, not back to exile.
In Commander, madness shines with looting/rummaging effects, "wheel" payoffs, and cards like Anje Falkenrath that turn discards into free spells, generating card advantage from what looks like card disadvantage.
Iconic cards with Madness
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