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Despite its potential for social impact, current approaches to design activism can be extractive and at odds with community-aligned advocacy. Drawing on interviews with 32 individuals who use design to address local, social inequities, we extend the current discourse around design activism by exploring 'activist-led design'. We outline four key considerations of this work: understanding activist-led design practices; relationality and community engagements; challenges of doing this work; and democratizing access to design. Our analysis highlights implications for academia's role in design activism. This paper interrogates design activism's role as a social and communal practice, and considers ways to support activist-led design. 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