In a large mixing bowl, combine ground turkey, soaked breadcrumbs, minced onion, garlic, egg, chopped fresh sage, Italian seasoning, and grated Parmesan cheese. Mix gently until just combined.

With damp hands, scoop small amounts of the mixture and roll into meatballs about 1.5 inches in diameter. Place on a plate.

Heat a large skillet over medium heat and drizzle in olive oil. Add the meatballs and sear them for about 5-6 minutes until golden brown.

In the same skillet, reduce heat to low and add pumpkin puree, heavy cream, and reserved fresh sage. Stir and let simmer for 3-5 minutes.

Carefully return the meatballs to the skillet and let them simmer together for about 5 minutes.

Plate the meatballs atop a bed of your choice, spoon the creamy sauce over them, and garnish with additional grated Parmesan.