Once you've set the button to be a macro-type button, you can just drag and drop spells/abilities or items onto the button, and Macaroon will automatically write a macro for you. You can even drag and drop macros from one macro button to another. The only thing you can't do is drag and drop a Blizzard macro onto a Macaroon macro button; in that situation you would need to copy the Blizzard macro's contents, and paste them by hand into the Macaroon macro editing window.
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