LET'S BUILD A WORLD

I wonder,
I wonder about fantasy world. How they are shaped, how some tend to make them full of unpronouncable places, how they are big or small.
Some creators have a new one for every game or two. Some are able to stick with one and develope its history and geography. You can even return to same characters.
My approach is to make worlds small. Nations have thousands of citizens, some are even smaller. We all see that a village has five houses in-game. There can't be more than 20, 30 people in it.
Usually, i inspire my settings with some 10th century. There is no progress, zealots are everywhere and old gods are slowly pushed back. I like adding flavors from other continents then Europe and other times. I like pre-feudal Japan for example, nations of the Middle Asia or Pre-Columbian America. These are usually fantasy settings and to be honest, they are the first and the most obvious choice of mine.
What is your approach?