The Realm won't create any automatic backups. Neither the usual backup every 30 minutes of a player being online, now the automatic backup when the last player leaves and the Realm shuts down.
The only way to create a backup is for the admin to close and re-open the Realm manually. This however consistently takes up to 8 minutes.
After a bit more than one hour of constant play the Realm will suddenly crash, simply prompting the players with "Timed Out". Up until the crashes, performance is fine (apart from the missing backups).
When the Realm evenutally restarts after a crash, the last backup is loaded, which will be from before the last session.
The issues only arise on our main survival map, which has grown to be 23.5GB in file size. We suspect the file size to be the issue, because it is stated during download that a map of this size will not be uploadable again. This did however start happening with the upgrade of Java Realms to Minecraft 1.19.3, but this may be a coincidence.
In singleplayer, there are no issues with the map. The Realm has no issues whatsoever running other maps, all under 5GB of file size.
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Hi! I play on my friends server and we are also been having this issue a lot. Game times out and when we get back to server it goes back in time a lot ): we have a lot built in the server so i wouldnt be surprised about being a size issue either,

Issue still exists as of 1.19.4; I have the same experience where all players get kicked and it rolls back... Same larger world size, and same case where it started around the 1.19.3 update.

Just fyi that your ticket will likely be closed, I had a similar issue, but my ticket was closed and linked here, maybe if we can get some traction on this issue Minecraft will finally address it after 3 years: REALMS-4224

Going with the assumption that the file is too large:
I have now downloaded the map and used MCA Selector to delete all chunks that hadn't been visited for more than a minute (useless chunks generated during exploration). Doing this on all three dimensions shrunk the file size from 25.6 GB to 1.9 GB (!!).
The trimmed map is re-uploaded to the Realm and perfectly functional. Backups are loading fine and there are no more crashes. Everything important on the map is still there and the file was just unnecessarily inflated. I am personally very happy with this bandaid fix.
I can confirm this is a real issue, and it is 100% related to the file size. I keep having to close the game to force it to create a backup. This is a 1.19.3 issue, it only began occurring when I updated, so it's not a coincidence. If there's any solution, let me know, playing the game is near impossible.