If your using Microsoft System Center Operations Manager to monitor agents that are in an untrusted domain, DMZ or work group environment the chances are your going to deploy a gateway server to support PKI authentication (certificates), apposed to the standard kerberos authentication.
When you run the below command you might notice that it seems to hang/stall.
microsoft.enterprisemanagement.gatewayapprovaltool.exe /managementservername=fqdn.management.server /gatewayname=fqdn.gateway.server /action=create
The command should only take about 15 seconds to run, even on the slowest of servers, so you probably have an authentication issue somewhere.
Basically the command performs some SQL changes, therefore your logged in user account probably doesn’t have the required permissions on the SQL server.
The fix is normally just login temporarily as the domain administrator, as that will have the required permissions.