Incident ¹H⁺ and ⁴He⁺ ions at 0.3-2.6 MeV and ¹⁹F^q⁺ ions at 25, 27 and 35 MeV were used to study the M-shell x-ray production cross sections of Au, Pb, Bi and U. For the incident fluorine ions, projectile charge state dependence of the cross sections were extracted from measurements made with varying target thicknesses ( ~1 to ~300 μg/cm²). The efficiency of the Si(Li) detector was determined by measuring the K-shell x-ray production of various low Z elements and comparing these values to the prediction of the CPSS theory. The experimental results are compared to the prediction of first Born approximation for direct ionization to the continuum and to the OBK of Nikolaev for the electron capture to the K-, L-, M-...shells of the incident ion. Comparison is also made with the ECPSSR theory that accounts for the energy loss, Coulomb deflection, and relativistic effects in the perturbed stationary state theory.