First confirm that you have downloaded the Poised app for Mac. This will not work if you are still using the browser. To download from the browser, go to https://app.poised.com/settings/ and scroll down.
Next, make sure you have the right permissions in place.
System Preferences
Privacy & Security
Microphone
Make sure Poised is turned on as displayed here.
Then, make sure your speaker and mic are set up correctly in the Poised app. Within the Poised mac app, navigate to Settings (the gear icon at the top) and then the recording tab.
Make sure your Audio Settings for both Speaker and Mic make sense.
Finally, check your meeting provider (Zoom, Google Meet, etc.) and see if Poised Speaker is showing up as an option in the Speaker settings.
If that still doesn't work you may need to restart your computer for the audio settings to take effect.