A cam roller follower diameter is a function of several factors. The roller diameter used on translating followers of pushrod OHV engines is based on the cam base circle diameter, the cam lobe lift, the max pressure angle at the lobe flank/roller contact, the max contact stress allowable at the roller/lobe contact, and what roller size can be accommodated by the lifter body. Changes to the diameter of the roller follower must be considered in the context of the entire valvetrain. Even a small roller follower diameter change will alter the kinematics in the valvetrain.
The typical roller lifter used in American pushrod V8s has a diameter and width that allows it to fit inside the lifter bore in the block. A small diameter roller follower allows a more aggressive lobe profile than a flat face follower. The lobe lift profile that can be used with a flat face follower is limited by the lobe's radius of curvature. As the lobe radius of curvature becomes larger, the face diameter of the flat follower must get smaller.