They are a little tedious to work with. I recently made over 300 of these for a wholesale order. I thought I was going to die
Sometimes it helps if I use an alligator clip to hold the folds as I go. Another tip would be to make sure the angles of the ribbon are just right before you sew it/tie if off. It really matters even more with these little guys than on the larger bows.
Here's a picture of one I made with 3/8" ribbon. I do another size even smaller than this one!