Mostly the kitchen sink - a country for each theme - approach, that makes the various regions seem disconnected, with clear borders between the orc and monster federation, the gothic horror people, the high tech robots and the medieval Russians and so on...

It's gets a bit better further south, where there are actual relationships detailed between the various - clearly political - entities, including a history and all that.

This extends to throwing in the Cthulhu Mythos and other such inclusions, it makes it all feel inorganic and unfocused, a patchwork without a real history and net of relationships to hold it all together.