The activity of the muscle-type Torpedo nicotinic acetylcholine receptor (nAChR) is highly sensitive to lipids, but the underlying mechanisms remain poorly understood. The nAChR transmembrane α‑helix, M4, is positioned at the perimeter of each subunit in direct contact with lipids and likely plays a central role in lipid-sensing. To gain insight into the mechanisms underlying nAChR lipid-sensing, we use homology modeling, co-evolutionary analyses, site-directed mutagenesis and electrophysiology to examine the role of the α-subunit M4 (αM4) in the function of the adult muscle nAChR. Ala substitutions of most αM4 residues, including those in clusters of polar residues at both the N and C termini, and deletion of up to 11 C-terminal residues had little impact on the agonist-induced response. Even Ala substitutions of co-evolved pairs of residues at the interface between αM4 and the adjacent helices, αM1 and αM3, had little effect, although some impaired nAChR expression. On the other hand, Ala substitutions of Thr422 and Arg429 caused relatively large losses of function, suggesting functional roles for these specific residues. Ala substitutions of aromatic residues at the αM4-αM1/αM3 interface generally led to gains of function, as previously reported for the prokaryotic homolog, the Erwinia chrysanthemi ligand-gated ion channel (ELIC). The functional effects of individual Ala substitutions in αM4 were found to be additive, although not in a completely independent manner. Our results provide insight into the structural features of αM4 that are important. They also suggest how lipid dependent changes in αM4 structure may ultimately modify nAChR function.