Julia has macros denoted by an at-sign (e.g. @inline) to make clear that something special is going on. Understanding how to write effective macros takes some work - perhaps more than Lisp; I can't fully say, myself - because expression representation is less apparent to the casual user. This, combined with an emphasis on "don't use macros when a function will do", seems to have lead to fairly judicious use of macros in most of the code I have seen.

Good tooling can also help with the locality problem. For example, by showing macro expansions in-place when possible (and desired).