Competitive Hexakill?
I personally think that with a 6th player on the rift alot of laning strategies that are not viable with 5 people suddenly opens up, such as double jungle + standard lanes, trilanes to shut down the enemy duo, 2 duo lanes, etc. Gold distribution will also be a much bigger deal than on live rift as you now have 6 players but only can afford farm for 2 carries, making the 6th position extremely flexible.
I also think that with these strategies, niche picks and innovative strategies will be very important such as
being one of the few ADCs that can actually farm against a trilane, or sending
to 1v2 or 1v3,
being a niche pick against double jungle,
double jungle lvl 1. dragon, etc. It will also automatically balance duelist champions like Vayne, Fiora, etc. because even fights will no longer exist by default; instead, the fight can be anywhere from a 2v1 lane in your favor to a 2v3 lane against you.
Ranked Hexakill IMO would force players to think on their feet and make team comps not just from the most OP champs, but using niche picks, creative laning strategies and good gold distribution in addition to all skills needed on current ranked to win.