I’ve made it dozens of times and eaten it much more often. What’s most important to know is that there are two basic types…Hiroshima-style and Osaka/Kansai-style. Both are very good, but quite different. Hiroshima-style is, IMHO, more difficult to make as the base batter is spread out crepe-style and less forgiving.
Osaka/Kansai style is basically all mixed in. However, if you use pork for the meat, you put that on the griddle/frying pan and then place the batter mixture on top of it. If you use seafood, mixing it in the batter along with the cabbage, etc is fine.
As for sauce, mixing Worcestershire sauce with ketchup is OK, but I wouldn’t do it. If you can’t get okonomiyaki sauce, an absolutely perfectly acceptable alternative is tonkatsu sauce. For Hiroshima-style, the sauces are quite a bit different from Osaka/Kansai-style in taste…but the difference is hard to describe.
“Okonomiyaki” translates to “cook to your liking”, though and to be brutally honest, there are no rules written in stone about the recipe.
However, I lived in Osaka/Kansai and Tokushima for approximately 20 years and because of that, I have a biased preference for Osaka/Kansai-style.