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No they aren't. The only oddity we've ever had is the whole Unova/Sinnoh thing, which you can argue is more teleport magic than a physical cave.
Also in most cases they are countries.
>Galar
Is the entirety of Britain, so multiple countries that have united, the map is upside down however, you can argue this is because it was drawn that way or some geographical nonsense happened in this world.
>Paldea
An entire country, the Paldean Empire likely took control of the Portugal region
>Kalos
The entire country, Southern Kalos still exists, we've just never seen it
America/Japan are the oddities.
Japan is in a more feuding war states, where each region has become a defined country, with Kanto/Johto being more connected than anywhere else, probably due to them having both of the former Japanese capitals in Tokyo/Kyoto equivalents. And America is divided, Hawaii is still it's own place (makes sense, it's an isolated island), NYC has expanded and become more of a City State, assuming the country of USA still exists, and Orre (canon or not) has expanded into Sinaloa, Baja California, and a tiny portion of Southern California. This makes sense if we assume that Japan/USA got into a war like Surge hints at, that caused the collapse of the two to some degree. This also makes sense why NYC would have a desert, it was probably destroyed/nuked at some point, and enough time has passed that these two areas of the world have stabilized once again, and Surge is just recounting history, with Japan/USA still have animosity and small wars still.
