It'd work the same way. Everything divided into the same size precincts no matter whether rural or urban.
That way you have the same number of voters for all polling locations, and all polling locations are local to where those people live.
....and be manned by some of those same local people.
Aren't all dem strongholds that way?
Of course not. After all, as long as ones side is always the winner, one would never notice any problems.
If Philly went red in the last election, would you still see everything that way? Or might you have thought shenanigans could be afoot?