I tend to make up my own patterns a lot. I sometimes use graph paper to draw them out on and sometimes, I just start cutting and sewing and see where it takes me. My avitar is a baby quilt I designed and made from my stash for my youngest DGD. My DD said she wanted to do her nursery in hot pink and zebra and would I make a quilt for it. I did and I made matching crib sheets too.
Sometimes, I use patterns. I usually buy patterns at quilt shows. You get the newest ones there. Patterns are a great source of ideas.