Custom code (such as LUA code) cannot be executed, making most custom logic impossible. Modding for this version of the game is limited to replacing existing files.
To properly install mods for this version of the game, you must place what is inside of the mod's resource folder into the resources folder at the file path above. Library/Application Support/Steam/steamapps/common/The Binding of Isaac Rebirth/The Binding of Isaac Rebirth.app/Contents/Resources/resources Steam/steamapps/common/The Binding of Isaac Rebirth/resources Mods made for Rebirth & Afterbirth must be installed manually into the game's resources folder.