Kensington Trackball scroll ring only works in one direction when BTT is running

For some reason, whenever BTT is running on my system, the scroll ring on my Kensington trackball (wired ExpertMouse) will only scroll in one direction. In order to scroll in the other direction, I have to quit BTT.

I've looked through all the preferences and I dont see what could be causing this. Any pointers would be super appreciated!

Do you have any other mouse related apps installed that could conflict with BTT? (E.g. Steer Mouse)

I have a Magic Trackpad 2 (connected via Lightning cable instead of bluetooth), Wacom Intuos Pro tablet (also connected via wired), as well as 3 Stream Decks (two XLs and 1 15-key).

I'm running Keyboard Maestro, but dont use it for anything related to mouse/trackpad scrolling.