It works, but I unpacked the XPI, (just convert it to a zip in your extensions folder if you want to see for yourself) and the code just seemed generally suspicious at a glance,(it also requires access to all sites???) so I got rid of it. If you want a working addon, check this git.
github.com/EltonChou/TwitterMediaHarvest/releases

require access to ALL sites, instead of X Twitter websites! a spyware behavior!

Works out of the box

simply works, idk why it has so few reviews, one that has more reviews didn't work and this one did
edit: i think i figured out why it has so few reviews, twitter is misspelled in the extension name

Doesnt work.

the least worst of all the extensions seen on the subject

Yes