Its Bloodthirst ability lets it come in with +1/+1 counters based on damage dealt to your opponents, and its Enrage effect lets it deal damage to an opponent, each time it takes a hit, unless they sacrifice a (non-token) creature
Illustrated by Ron Spears Standard Legal Alchemy Legal Pioneer Legal Historic Legal Modern Legal Brawl Legal Legacy Legal Comp
Then that six-drop Naya colored 4/5 legendary is next with haste to swing now, first strike to punch first and then vigilance to keep stuff back
A different build would be focused on blink and creatures that have good enter the battlefield effects and higher toughness than power, like Sea Gate Oracle, Brago, King Eternal, and Wall of Omens / Wall of Blossoms
The caveat is Medomai can't attack during extra turns, meaning you need ways to get around that pesky restriction