I quilt using a DSM - but my quilts are small. The biggest one I’ve made was a lap quilt. I have not mastered free-motion quilting yet - I usually Stitch-in-the-Ditch or a quarter inch from the ‘ditch’. I can also do wavey lines.
When I start quilting I roll the part of the ‘sandwich’ that is going to go through the well (is that the right name?) of the machine and clip or pin the ends of the roll to stop it unrolling. Then I work from the centre, sometimes from top to bottom, or centre to top then centre to bottom.
Don't tell the Quilting Police but every now and again I take the quilt away from the machine, spread it out on a table and check that there are no puckers or problems on the back. If there are I sort it before I continue.
When I prepare my sandwich I use safety pins. I will also use straight pins - the long ones with flat heads - and pin just the section or block I am working on as it goes through the machine. This does involve a lot of stopping and starting but it works for me.