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Conceptually I've always found the idea of basing regions off specific countries limiting since there's a lot of interesting locations you could incorporate
Particularly the US because of its size.
Somehow I think basing it off a section of a real place allows you to ground it in a level of realistic geography. I love Hoenn to death but it is a little odd to have a tropical Okinawa setting with a desert.
Sinnoh, Johto, and Kanto on the other hand are pretty consistent in how biomes and landscapes fit together.
Having fire area, water area, desert area, jungle area, etc all in one region like a Mario game takes away from immersion