You don't need that many people to have cafés with outside seating. Basically speaking, if your town is big enough to have a pedestrian zone it's big enough to have those. Heck, my hometown lacks a café or a pedestrian zone but does have a bakery with outside seating and it's rural enough that you can smell the pig stables from any point in town.

It's more a question of whether you're willing to dedicate space for people to be outside (rather than just traveling from A to B) and whether people actually want to be outside. Culture matters a lot here. Where I'm from people will happily use outside seating right next to a busy arterial road because sitting outside when the weather is nice is seen as desirable.

As for urban vs. rural, a six-lane road practically screams "urban sprawl"; that's the kind of road generally associated with major population centers in Europe. I know that many municipalities in the States like to overbuild their car infrastructure to the point where you can walk nowhere and then wonder why there's so much traffic. But from a European perspective that very much looks like a commercial zone on the outskirts of a big city.

Every cafe in Australia has this same arrangement. Tables spreading outside, crammed inside, fucken amazing coffee and often tons of people.