Project Zomboid 42.3.0 UNSTABLE released today[theindiestone.com], including a small change/fix for moodles:

- Fixed Moodle Size option not affecting the displayed moodle size immediately.

As a result, moodles created with Moodle Framework will now display at the incorrect size relative to vanilla moodles if moodle size is adjusted while actively in-game.

Reloading the save after changing moodle size still works as before and can be used as a workaround until the mod is adapted.

EDIT: The Mar 10 update to Moodle Framework fixed this problem.