Gather and prep all of your turkey meatball ingredients according to the ingredient list above.
In a large bowl, add the breadcrumbs and pour over the milk. Let them sit and soak for 2 to 3 minutes. Then, add in the onion, garlic, sage, parsley, Italian seasoning, parmesan and whole egg plus yolk, and mix together to thoroughly combine.
Add the ground turkey, salt, and pepper, and gently combine all the ingredients just until well combined. The mixture will be very sticky and moist; this is normal.
Using a 2 tablespoon scoop, portion out your turkey meatballs onto a parchment or wax paper-lined large platter. Place the meatballs into the freezer to chill and firm for 20 to 25 minutes.
Once chilled, lightly wet your palms with water or a small amount of oil, then roll each meatball between your palms to make them round.
Brush a small amount of olive oil over each meatball. Heat a large skillet over medium-high heat and drizzle in about 4 tablespoons of oil.
Add a batch of turkey meatballs to the skillet, searing and browning them for a moment before reducing the heat to medium or medium-low. Cook on all sides for about 10 minutes until cooked through (165° internal temp). Set cooked meatballs onto a clean platter and repeat with remaining meatballs.
Gather and prep all of your pumpkin sage sauce ingredients according to the ingredient list above.
Wipe out the skillet and add in ghee (or butter) along with the oil. Once melted, add in minced onion and sauté for about 2-3 minutes until softened.
Stir in garlic and Italian seasoning; once aromatic, whisk in pumpkin puree, salt, pepper, and chicken stock until smooth.
Allow sauce to gently simmer for about 2-3 minutes, then turn off heat and whisk in grated parmesan, heavy cream, maple syrup, and chopped sage.
Add meatballs into sauce, allowing them to warm through again; top with fried sage leaves if using, then serve over preferred accompaniment such as gnocchi, linguini, penne, bow ties, or mashed potatoes.