My macros for SMN were pretty complicated to write, but once implemented, it was super easy to use. There was one macro for summoning each beasty then one that ran through the list of all the blood pacts at the same time. Like on each line it had one blood pact, and etc. By that extension, only one would work depending upon which beasty was out.
Now my RDM macros... those were a bit more difficult. Before casting a spell I had to choose a category first. I had categories like Heal, Buff, Enfeb, and then when I clicked on one of those, it would take me to a subcategory of spells to choose from. Each macro also had a mass of gear changes as well. Then to get back I had a "main" macro. It's hard to use at first because if I need to get a cure off immediately, I have to run through a list of macros to get there, but once I had the locations of the categories and spells memorized, I was flawless.
edit: The things I did to play on Xbox...