Begin by soaking the fresh breadcrumbs in milk for about 5 minutes until they absorb the liquid.

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

Shape the mixture into golf ball-sized meatballs and place them on a parchment-lined baking sheet.

Heat olive oil in a skillet over medium-high heat and sear the meatballs for 6-8 minutes until golden brown.

In a saucepan, combine pumpkin puree, heavy cream, salt, and pepper over medium heat, stirring in sage and simmering for 5-7 minutes.

Add seared meatballs to the sauce and let simmer for 5 minutes, stirring occasionally.