When starting ioquake3 for the first time using the MacOS App bundle from https://files.ioquake3.org/macOS.zip it requests OS folder access, however the dialog can not be accepted as mouse and keystroke inputs are disabled by the app. There is no way to exit the app or return to the desktop so you have to hard reset the OS. The only work around I found is to launch quake ioquake3 in window mode by setting seta r_fullscreen "0" in the config. Then when the security access prompt comes up you can accept it.
When starting ioquake3 for the first time using the MacOS App bundle from https://files.ioquake3.org/macOS.zip it requests OS folder access, however the dialog can not be accepted as mouse and keystroke inputs are disabled by the app. There is no way to exit the app or return to the desktop so you have to hard reset the OS. The only work around I found is to launch quake ioquake3 in window mode by setting seta r_fullscreen "0" in the config. Then when the security access prompt comes up you can accept it.