We investigate existence of dual optimizers in one-dimensional martingale optimal transport problems. While [BNT16] established such existence for weak (quasi-sure) duality, [BHP13] showed existence for the natural stronger pointwise duality may fail even in regular cases. We establish that (pointwise) dual maximizers exist when $y\mapsto c(x,y)$ is convex, or equivalent to a convex function. It follows that when marginals are compactly supported, the existence holds when the cost $c(x,y)$ is twice continuously differentiable in $y$. Further, this may not be improved as we give examples with $c(x,\cdot)\in C^{2-ε}$, $ε>0$, where dual attainment fails. Finally, when measures are compactly supported, we show that dual optimizers are Lipschitz if $c$ is Lipschitz.