It has little to do with middle America. I am sure there are people in every state of U.S. who saw Trump for what he his in 2016. Do not blame your ignorance on your proximity to Mississippi River.
People of reasonable intellect knew Trump did not build most of those buildings with his name on marquee.
People of reasonable intellect knew if he placed money he inherited from his father in S & P 1500, he would be far wealthier than he is.
People of reasonable intellect knew he was a fraud when N.F.L. realized Trump never was a real billionaire. N.F.L. would not allow Trump to buy Buffalo Bills because N.F.L. figured out Trump was not anywhere near billionaire status.
People of reasonable intellect knew his leadership & managerial style would lead to eventual disaster.