If $A$ is a $\sigma$-unital, simple, non-unital $C^\ast$-algebra, then $M(A)$ is non-exact (in particular, it is non-nuclear). The following argument is modelled after Yemon's idea in the comments above. Also, it uses the very deep theorem of Kirchberg, that quotients of exact $C^\ast$-algebras are exact (this can probably be avoided).
If $A$ is type I, this is the fact that $B(H)$ is not exact, so we assume that $A$ is not type I. Assume for contradiction that $M(A)$ is exact.
Let $h\in A$ be strictly positive, $\| h \|=1$, let $t_1 > t_2 > \dots$ be in the spectrum of $h$, with $\lim t_n =0$, and let $f_n\colon [0,1] \to [0,1]$ be continuous functions of norm 1, supported only close to $t_n$ (so that all supports are mutually disjoint), such that $f_n(t_n) = 1$. Let $d_n = f_n(h)$.
It is easily seen that the map $(a_n)_{n\in \mathbb N} \mapsto \sum a_n$ (strict convergence) induces an embedding $\prod_{n\in \mathbb N} \overline{d_n A d_n} \hookrightarrow M(A)$. As exactness passes to $C^\ast$-subalgebras, it follows by our assumption that $M(A)$ is exact, that $\prod \overline{d_n A d_n}$ is exact.
As each $\overline{d_n A d_n}$ is not type I, a theorem of Glimm (Cor. 6.7.4 in Pedersen's book "$C^\ast$-algebras and their automorphism groups") implies that there are $C^\ast$-subalgebras $B_n \subseteq \overline{d_n A d_n}$ such that $B_n$ has a quotient isomorphic to the UHF algebra $M_{n^\infty}$. Hence $\prod_{n\in \mathbb N} B_n$, which is exact since it embeds into $\prod \overline{d_n A d_n}$, has a quotient isomorphic to $\prod_{n\in \mathbb N} M_{n^\infty}$. As quotients of exact $C^\ast$-algebras are exact (by a deep theorem of Kirchberg), $\prod M_{n^\infty}$ is exact. However, this has a $C^\ast$-subalgebra $\prod_{n\in \mathbb N} M_n$ which is then exact, hence a contradiction.