The world can and should be very large. However, if you initially restrict PCs to a small geographic area, you have to design less initially. This was my intent. I intended for the group to spend several sessions in Padmos, so I could more design Antioch more specifically. This did not happen.
The downside of this IMHO is that while I have pictures in my head of Antioch, I don't hav much detail about it to rely on. Still feels a bit nebulous to me.
Zach, if you are new to dming, start small.
The PCs are only locked into Alderweg as much as you want to be. Find yourself a Senechal and you are free as a bird

Or devote as much time there as you want. The game function it provides in my mind is: lets you see time pass, provides a home base to operate from, presents some plot hooks. I have intentionally left everything very open, probably too much so. In the last campaign I ran with Nathan, Steve, Dave etc, Steve had a sword that urged him to take certain actions. I found out later that Steve resented this becuase he felt the DM was doing the urging. Two lessons, one for players one for DMs. 1.As a player it is wrong (flat out wrong for emphasis) to assume that NPCs know more than you do. They are in no way the voice of the DM. Expediency sometimes demands that NPCs push the plot along (Miriam) but to assume that is not fair or wise. 2. As a DM, certain players desire high degrees of independence, while others will not act independently at all. We have both at our table. So I have erred on the side of: Heres the World, I'll throw plot hooks at you, pick the ones you want. Evetually there will be an Endgame, where the PCs will stumble on the Metaplot and will run to the end. Tada!
Adlerweg is not intentional small, so much as sheltered. It provided a plausible place for Keth Anar to be found, with a small village relatively near, as well as a bugbear community. The village was suppossed to have some tie with the dwarves, but I dropped that line because Dave seemed to have minimal interest in exploring dwarvendom.
Obviously playing once per month is not optimal for gameplay. For staying married however...