Threat Actors may establish persistence by executing malicious content triggered by the execution of tainted binaries. Mach-O binaries have a series of headers that are used to perform certain operations when a binary is loaded. The LC_LOAD_DYLIB header in a Mach-O binary tells macOS and OS X which dynamic libraries (dylibs) to load during execution time. These can be added ad-hoc to the compiled binary as long as adjustments are made to the rest of the fields and dependencies. There are tools available to perform these changes.
This type of attack technique cannot be easily mitigated with preventive controls since it is based on the abuse of system features.