Quite often the edges are folded down and hand sewn in a "knife edge" finish. A slightly easier variation to this is to basically applique the edges to a single band of background fabric.
I recently bought a top at a Goodwill which is very large (almost king sized) but made out of tiny little hexes (they measure 3/4" on the edge), I'm going to keep the overall in/out of the blocks but I am going to trim off the outer points and not do each tiny little hex. I'll be using a narrow French bias binding, I need to do some tests first to see the mechanics of how much/what angle of fold to use but am not going to be too worried on what it looks like on the back...
With the quilting design I have planned, it will work well as I will simply be quilting around the "paths" of each flower, with a more complex design on the inside of each. Basically the outer edge will be where the quilting line is in the other blocks. In order to do the quilting on a long arm, I'll need to attach the outer edges to strips of fabric first. It's going to be a challenge to me! But I am willing to work on the quilting and binding on the finished top even if I an fundamentally unprepared to do the handwork required for the top.