The Crazy quilt style spread to communities throughout the United States, and some groups incorporated it into quilt formats they already favored. Often, they adopted the style well after its peak of popularity in the 1880s. In the early twentieth century, Amish women sometimes used Crazy quilt elements, including Crazy patchwork and fancy stitching (though usually not the abundant imagery seen in Victorian Crazies) in quilt formats typical for their community. For instance, setting Crazy quilt blocks within the wide, dark, quilted borders that characterize Lancaster County, Pennsylvania Amish quilts was a distinct sub-practice in this region. Amish women in other parts of the country made more workaday cotton Crazies, similar to string quilts from the rural South.

These so-called “string” quilts, which utilized the narrowest fabric scraps by sewing them onto a foundation block one after another, were a staple style, especially among rural, southern, small-farm quiltmakers, both African-American and white. Because each “string” was a different width and shape, the blocks they produced could create a haphazard appearance.

Decades later, in the mid-twentieth century, the Crazy style took on a new look in Hawai’i, where locally made “aloha” shirt fabrics became the material of choice. After Hawaii became an American state in 1949, tourists flocked to the islands and brought home souvenir shirts featuring bright colors and tropically themed designs. The scraps from this local industry were incorporated into a geographically-specific expression of the Crazy aesthetic.

In Asia, scrap quilts with visual similarities to Crazy quilts have been made in several different regions. Boro quilts, for instance, are a rural Japanese bedcover  composed of patches upon patches of indigo fabrics, most of which are recycled from other domestic items such as clothing and bedding. Similarly, in India, women recycle their old saris (wrapped garments) and transform them into quilts by layering piece after piece on a foundation fabric, then holding them all together with quilting stitches. In Korea, women have long made patchwork wrapping cloths, or pojagi, using small pieces of irregularly shaped silk or ramie to compose their exquisite and often ephemeral pieces.