There are two measure measurements you may be confusing: pixel pitch (the distance between the center of one pixel and the center of the next pixel), and pixel size (the diameter of a single pixel). Pixel size is always smaller than pixel pitch, because there is always a certain amount of space between one pixel and its neighbors, used for row/column wiring, reset & buffer transistors, and other things. The measurement you care about is pixel pitch.
Both are as accurate and consistent as the chip manufacturers can make them; chips are fabricated with a series of masks that must align very precisely for the transistors and photodiodes and wiring to connect properly.