You'll want to make sure you have NodeJS installed on your computer. Then, setup is as simple as:
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npx add-gitignore
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If you've got an older version of node that doesn't yet have npx, here's a more traditional setup:
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npm i -g add-gitignore
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add-gitignore macOS Emacs node # or whatever you need
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Alternatively, running just add-gitignore gives you a nice multi-select interface from which you can choose what to ignore, and using the --help flag helps you out.