Can no longer open BTT since my OS update.

I have macOS Catalina 10.15.7 and I think since this update, I can no longer open BTT.

I've tried removing and re-adding in accessibility and then restarting, but that didn't work.

Not sure what to do.

Are there any crash reports for BetterTouchTool in the macOS console app?

Possibly try to reset the macOS Accessibility database using this terminal command

sudo tccutil reset All com.hegenberg.BetterTouchTool