I used the acme-dns server (https://github.com/joohoi/acme-dns) for this. It's basically a mini DNS server with a very basic API backed with sqlite. All of my acme.sh instances talk to it to publish TXT records, and accepts queries from the internet for those TXT records.

There's a NS record so *.acme-dns.example.com delegates requests to it, so each of my hosts that need a cert have a public CNAME like _acme-challenge.www.example.com CNAME asdfasf.acme-dns.example.com which points back to the acme-dns server.

When setting up a new hostname/certificate, a REST request is sent to acme-dns to register a new username/password/subdomain which is fed to acme.sh. Then every time acme.sh needs to issue/renew the certificate it sends the TXT info to the internal acme-dns server, which in turn makes it available to the world.