Here's how I make MSPFA sprite backgrounds.

This is the grid I made and use specifically for making rooms.
So I drag in sprites for height reference, then I do a light sketch over the grid.
Then following the sketch, I very loosely line over it. I don't strive for perfection, which while being in perspective to the grid still gives it an element of imperfection. Thus a "hand-drawn" look
Use line thickness variation as you're making lines, erase chunks out of them.
The rest is history.

Just clutter and random items of interest pertaining to the character.
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