Once you've launched an ad through Ads Manager, it will go through Facebook's automated review process. Most ads are automatically approved and will go live on Facebook within about 30 minutes.
If for some reason your ad is not accepted through Facebook's first review process, then it may take up to a day for the ad to post. In this case, your ad will show "Paused" in Ads Manager until Facebook's review is complete and the ad has been launched.
If your ad has been set to "Paused" for more than about 24 hours after launching it, please reach out to PSAI Support so that we can assist you. Fill out a ticket at this link, or open the Help widget in the bottom right corner of the screen.