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It is said in the beginning there was only the Far Realm, the original essence of the universe which spat out a thousand profane beings. Choronzon not only acts as a god of the original lands of madness, but is said to actually BE the gateway between the material and the physical. It is rumored that he is actually not originally a god, but an Elder Evil. Others say he was given flesh as an essence of the original link between the material and the realms of madness, this being a visage greatly reduced in power of his former glory that wishes to return to its full strength and true, unknowable far realm form that spreads across existence. As it is, it appears as a massive worm with a thousand glowing eyespots, its tooth filled maw dwarfed by its bloated, twitching bulk. Its mouths are gateways into the heart of the far realm and thus it is not terribly incorrect to say that the far realm exists inside of Choronzon. Then again, terms like "inside and outside" have little meaning in a land where parallel lines intersect.
Choronzon is a god of the Nibiru Pantheon.
Choronzon only desires to return the universe to its former truth state, which is to say it wishes to devour the material world and make it the far realm again. Fortunately his influence is minor, yet he still commands the power of a greater deity, giving some truth to the idea that he was born stronger, and that he may not be a true god at all.
Clergy and Temples
Only the mad follow Choronzon. Perhaps they sought forbidden knowledge, or some terrible experiment went wrong. Or perhaps they are already mad, desiring entropy to devour the world. Regardless, there are (fortunately) not enough of them able to synchronize to build any sort of temple.