Some regions will have great difficulty tackling local problems such as traffic, infrastructure, and the maintenance of local institutions due to poverty. A lack of centralization can sometimes mean poorer regions that are unable to help themselves are abandoned. 
There are many versions of federalism, and many do not delegate regional powers in a meaningful way. Striking the balance between local and national issues is difficult. Many people disagree on what the central government should do, and what should be left to local government. Often local government is required to solve its own problems without having the powers to do so. Often the central and local governments will shirk responsibility for the same issue.
Far from being more efficient federalism can make government extremely inefficient. The organs of government are multiplied to create multiple competing bureaucracies, which are frequently poorly connected to each other.
Federalism does not suit regional governments that are poor or lacking in resources. Striking the balance between national and regional powers is difficult and sometimes results in a system where nobody is held accountable for things that do not get done. Having many governments leads to a larger more confusing bureaucracy.