Mix the Meatball Ingredients: In a large bowl, combine ground chicken, canned pumpkin purée, plain breadcrumbs, egg, minced garlic, onion powder, salt, and black pepper. Mix gently until just combined.

Form the Meatballs: Use damp hands to scoop about 1.5 tablespoons of the mixture and roll into balls, making about 16 meatballs total. Place on a parchment-lined baking sheet.

Cook the Meatballs: Heat 2 tablespoons of olive oil in a skillet over medium heat. Add the meatballs in a single layer and cook for 2–3 minutes on each side until golden brown.

Prepare the Cream Sauce: In a saucepan, melt 2 tablespoons of unsalted butter over medium heat. Add minced garlic and fresh sage, cooking for about 30 seconds until fragrant.

Add the Cream and Seasoning: Pour in 1 cup of heavy cream and season with additional salt, black pepper, and nutmeg. Simmer gently for 3–4 minutes until thickened.

Simmer the Meatballs in Sauce: Transfer the meatballs into the sauce and let simmer for 5–7 minutes until fully cooked to an internal temperature of 165°F.

Serve and Garnish: Plate the meatballs with extra sauce, garnish with chopped sage, and serve with pasta, rice, or crusty bread.