I am not sure about the US, but in the UK you are missing whole chunks of towns and areas, making it difficult to use the local rnakings. For example, there is a borough called bromley, which includes towns such as bromley, orpington, beckenham etc, all larger than other towns you have, yet they are all missing. Lots of london boroughs are also missing
Thanks for highlighting the issue, @Oak SEO ! Research the reasons of this problem.
The problem that we had an outdated datebase of local regions. Now it is up to date, but some regions are available only by postcodes, not but full name. We use this database from Google - https://developers.google.com/google-ads/api/data/geotargets