I propose that orc strongholds be handled as factions, with full quest lines (not padded with radiant fetch quests) that end with the stronghold(s) of the player's choosing expanding to the size of a city. On the way, there could be civil war style battles between forsworn and orcs, nords and orcs, and maybe even orcs and draugr as the orcs secure more territory for their strongholds. It'd also be nice to see orcs wearing more than furs and using better weapons than iron and steel since they're supposed to be the best armourers in the whole damn world.
As a side note: I think the orcish armour in Skyrim is terribly ugly. In past games, orcish armour has been ornate and finely crafted and now it's just flat, green crap. Maybe a set of armour called "Fine Orcish Armour" could be added that's more consistent with the appearance of Morrowind and Oblivion's orcish armours and maybe on par with Ebony in protection.