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Your first preset

This is the whole setup, start to finish. It takes about five minutes, and most of that is macOS asking for a permission. By the end your controller moves the pointer, clicks, scrolls, and types, in every app on the Mac.

Steps

Install InputConfig from the Mac App Store and open it. It needs macOS 14 or later.
Connect a controller by USB-C cable, or pair it in System Settings, Bluetooth. It appears at the top of the sidebar within a few seconds, with its battery level.
In the sidebar, open the Desktop & Productivity folder and click Desktop Navigation.
Click Activate. macOS asks for Accessibility permission the first time; open System Settings, Privacy & Security, Accessibility, and switch InputConfig on.
Move the left stick. The pointer moves. Press A / Cross to click, and use the right stick to scroll.
When you are done, click Deactivate, or hold the Home / PS / Guide button for two seconds. That hold is the emergency stop and it always works.

What the permission is for

InputConfig turns controller input into ordinary keyboard and mouse events, the same events a physical keyboard produces. macOS only lets an app do that with Accessibility permission, which is why it asks. The app never reads what you type in other apps; the permission is about sending, not reading. If you later use your Mac keyboard or mouse as an input, macOS asks for Input Monitoring separately, and the app explains why at that moment.

What Desktop Navigation gives you

It is the preset most people start with because it turns the controller into a complete mouse and a few shortcuts. Left stick moves the pointer, with variable sensitivity so a small push is precise and a full push is fast. Right stick scrolls. A / Cross is left click, B / Circle is right click. The bumpers switch tabs, the D-pad sends the arrow keys, and Start / Options presses Return. Every row has a note explaining itself, so the preset is its own manual.

Changing one thing

Click Edit on the preset to open the binding editor. Every row is one control and what it sends. To change what a button does, change the output menu on its row. To move a row to a different button, press Scan on that row and press the button you want; it is captured on the spot. Press Save and the running preset picks the change up immediately, without a restart.

Where to go next

If a keyboard is difficult for you, read using a Mac without a keyboard. If you are setting this up for someone else, the older parent guide is written for exactly that. For a game, the presets index has a ready-made layout for more than 450 titles.

Questions

Do I need drivers?

No. macOS handles the controller over USB or Bluetooth, and InputConfig reads it through Apple's own framework. MIDI devices are found automatically too.

Does it work with games that have no controller support?

Yes. The game sees a keyboard and a mouse, because that is what InputConfig sends. Any game you can play with a keyboard and mouse can be played from the controller.

Why does the pointer not move after I click Activate?

Almost always the Accessibility permission has not been granted yet. Open System Settings, Privacy & Security, Accessibility, and switch InputConfig on. If the app is on the list but still not working, remove it with the minus button and add it again.