The qualifying term is 'trusted'. If you are running an application like emacs you damn sure better trust it. It's like running Windows and saying you don't trust it.

AS for macros in lisp, they are not as ubiquitous as it might seem to an outsider. I write lisp professionally. I write one macro a month, if that, and often I rewrite it as a function afterwards. Saying that macros are ubiquitous in lisp is a meme. To most lispers macros are last resort