Xamarin Pair to Mac - Couldn't connect - Access to path is Denied

I recently wiped my Macbook Pro and I am trying to setup the "Pair to Mac" functionality in Visual Studio 2019 on my Windows machine. I also just updated Visual Studio 2019 on my Windows machine to 16.3.0. The Mac is running Visual Studio 8.3 (build 1805).

I receive an error when I try to Pair to Mac:

Couldn't connect to [ip address]. Please try again. XMA-Failed-dd7e7bf-Access to path '/Users/[user]/.config/Xamarin/Xamarin Messaging/1.1.6.217-d16-3+64904be' is denied.

I have Remote Login enabled, Firewall is off, Xcode 11 installed, xamarin-ios sdk installed.

It looks like a permissions issue but I'm not sure what else to check.

I'm also able to ssh into the Mac and run a successful 'ls' command.