How to "repair" a PDF that opens in Acrobat Reader but not Preview
I just had exactly the same problem. A filled-in PDF form from our tax service displays as follows in almost all PDF readers except Adobe's:



Not one of the normal solutions works. Every single macOS-native save-to-pdf or print-to-pdf option from within Acrobat Reader fails with "Saving a PDF file when printing is not supported."

I ended up having to use PDF-XChange Editor in one of my VMWare Windows guest images to open the offending PDF 1.7 form and then to print to the "Microsoft Print to PDF" printer driver.

A similar driver for macOS which could trick Adobe Reader into thinking that it was just a printer could also work, but I did not have more time to investigate other options.

There's NO reason for Adobe to make it this difficult to export a PDF form to read-only rendered version. Well, it could be because Reader has a truly subpar UI on macOS, so the company has to make use of alternative techniques to retain users.