Install the program and once installed, open Revit 2023 and go to the Mep Utilities tab. There you can see that the program has been correctly installed and is running. Note that without any programs, there may not be any internal buttons populated for the button list.

Use the MEP Utilities Startup button to load menu buttons and then once buttons are loaded you can use them to launch the sub programs.

Install: Double-click the .exe installer to install where you would like and follow the instructions.

To uninstall: double-click on the .exe and follow the instructions OR use the standard windows program uninstaller from Control Panel > Programs > Programs and Features.