One nice thing about Elixir for Lisp lovers is that you get "real" macros (full AST access within a quoting context) AND actual syntax. I am not sure there are any other languages which feature that combination currently.
It's pretty much the exact opposite in Elixir. The only thing you really have to wrap your head around is the switch between the quoting context and the unquoting context... which is pretty much no different from understanding macros period. The definition syntax looks just like a method definition, except it's "defmacro" instead of "def", and the macro body receives an AST instead of (or in addition to) your usual arguments. But I'm probably not doing it justice...
http://elixir-lang.org/getting-started/meta/macros.html
https://pragprog.com/book/cmelixir/metaprogramming-elixir
Here Dave Thomas creates a simple "returning" macro, you can just watch the screencast if you're feeling lazy: http://pragdave.me/blog/2014/11/05/a-simple-elixir-macro/
What does "actual syntax" mean here?
The fact that Erlang's syntax is (disclaimer: subjective) awful just adds further grist to the Elixir mill, assuming you think Elixir's syntax is (disclaimer: subjective) sweet.
Which a lot of people seem to be coming to the same conclusion on.
In Elixir, I have the full power of Lisp-level macros, in a functional immutable pattern-matching language, with a ridiculous level of concurrency (you can spawn a million or so processes in a second on your typical laptop), hot software upgradability (https://www.youtube.com/watch?v=96UzSHyp0F8 for a cool demo), access to the entire repository of already-existing battle-tested Erlang code...
... AND it's readable. :P
Lisp with its powerful macro facility has had literally dozens of years to find acceptance and still struggles (argumentum ad populum notwithstanding, a userbase with critical mass brings a plethora of other advantages). Ruby found enough of a niche that I think there is something to be said for Ruby's style of syntax. Elixir gives you both, and then some.