In C# you can put files in folders corresponding to their namespaces and view them in the Solution explorer.
In F# it seems I have to put everything
You can have folders in F# projects, too. It's a bit cumbersome, but it works.
I think putting multiple classes into one file is perfectly okay and idiomatic in F# if the classes are closely related to each other.
I have not yet worked with really large F# projects, but I'm also interested in the experience of others.