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Chapter 2: Building Games

Scope of Changes

Source GM Core pg. 63 2.0
It's up to you to determine how much of your game you want to customize. Many GMs use the default rules and creatures and set their adventures on Golarion or another published game world. Other GMs devise and incorporate all-new creatures and places with strange themes that don't fit in the standard Pathfinder game or world. Neither of these approaches is inherently better than the others. The most important thing remains creating a story collaboratively with the rest of your group while having fun.

Determining what your group wants out of the game and setting makes a big difference here. If you're playing Pathfinder with a major goal of exploring the Age of Lost Omens setting, it's more likely you'll use “stock” elements rather than creating new ones. On the other hand, it could be more interesting for your players to see brand-new things if they play with you to experience your own creative voice, or if they're experienced Pathfinder players looking for variety.