My problem was audio wasn’t routing out of Ableton properly which I fixed just using the external effect plugin. USAMO does work but it’s a little finicky. Sometimes the start / stop doesn’t sync properly and I’ll have to do it a few times for the timing to lock in. It does work though but it’s a little annoying having to restart the sequence sometimes 4-5 times to get the clocks in time.
I will definitely be investing in an E-RM Multiclock eventually which I have heard absolutely amazing things about. If that’s in your price range I’d say pick that up over USAMO.