Having problems with Direct Exporting from websites like PubMed? It’s browser related!
Use Firefox. Don’t use Chrome or Safari on a Mac.
https://support.clarivate.com/Endnote/s/article/EndNote-Direct-Export-with-Safari-or-Chrome-for-the-Mac?language=en_US
If it’s still not working, you need to configure your Firefox settings.
https://support.clarivate.com/Endnote/s/article/EndNote-Mac-Configuring-Firefox-Direct-Export?language=en_US