Acrobat Reader for Mac does not expose an Accessibility Tree to VoiceOver
Acrobat for Windows reads tagged PDF (aka PDF/UA) files and exposes an accessibility tree to assistive tech such as NVDA, Narrator, JAWS etc.
Acrobat for Mac does not do this. (And neither does Preview, or Safari). This means that the 'portable' document format is not accessible to Mac screen reader users at all. You can get the text nodes, but none of the semantic tags are respected.
Why is there such a discrepancy between accessibility support on the Mac vs. Windows versions of Acrobat Reader?
Mac Pro