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I definiteely don't have that much experience with Excel Macros these days, but my best guess is that this is a trust issue. When Excel is open, and the macro being run from within Excel, the Trust for the VBA project is defined, however when it's called programmatically, that trust has not been 'opened' yet.
That's just my best guess, and if that is the issue, there may be trust center settings that will fix it, otherwise, you may be able to convert the email process to an Alteryx Workflow.