Trouble Diagnosing Broken Email Opt-In

I use Mailchimp (not the plugin) to handle my email opt-in. It works wonderful! Except its completely broken only on Samsung mobile browser for android :/

I have yet to upgrade to a premium account to get support and I can’t find a lead to fix the solution to such a niche problem on any forums/FAQ/support.

Any ideas on where things are going wrong that I could try to fix this? I know most of my customers don’t use samsung browser but some do! Would love some thoughts!

Here are screenshots taken on from how it should look (Chrome) and then what broken Samsung browser looks like.