I've lived in a very expensive city and a medium cost of living city in the US and the lower quality of restaurants is the biggest difference for me.
There are some very famous and very expensive restaurants, but even those places have been disappointing too frequently. It's often something really basic like the food being too salty.
This wasn't as much of a problem in the very expensive city. It's unlikely that my taste buds have gotten more sensitive because I lived in the more expensive city at a younger age and taste buds get less sensitive as you get older to my knowledge.
Almost every attempt at finding a small town gem has not really worked out for me in the US.
In countries like France, I know that I can find small town gems just by checking the Michelin guide. I can go to Vonnas (population 3000) and find a great restaurant just by checking the Michelin guide. I would love to do that in the US.