Earlier this month, The Wall Street Journal reported that Trump had called Makary over a weekend to scold him for not moving fast enough to authorize flavored vapes, particularly menthol, mango, and blueberry flavors from the Los Angeles manufacturer Glas. The FDA authorized those flavored products days later and issued a new policy that would make it easier to market flavored vapes.

Officials in the Trump administration also noted that Makary had angered anti-abortion activists, who accused him of slow-walking a safety review of mifepristone, a pill used for abortion and miscarriage treatment.

Officials also said Makary butted heads with other health officials and was seen as struggling to manage his agency. He reportedly made enemies among lobbyists for the biotech, tobacco, and pharmaceutical industries. Public health experts, meanwhile, criticized Makary for changes to the FDA’s vaccine reviews under his watch, which aligned with Health Secretary Robert F. Kennedy’s anti-vaccine agenda.

“He has offended almost everyone involved in FDA issues, which is not easy to do,” Diana Zuckerman, the president of the National Center for Health Research, told the Times.

According to Politico, which was the first to report Makary’s resignation, it was Kennedy—not Trump—who made the call on planning to fire Makary, though Trump had to agree.