I begin by soaking the breadcrumbs in milk for a couple of minutes until they soften. Then I add minced onion, garlic, sage, parsley, Italian seasoning, Parmesan, egg and yolk, salt and pepper. I gently fold in the ground turkey—taking care not to overmix, since that can make the meatballs dense.
Once mixed, I scoop out the meatballs (I use about 2 Tbsp per ball) onto a parchment-lined tray. I chill them in the freezer or fridge for 20–25 minutes to firm up. Chilling helps them hold their shape when cooking.
In a hot skillet with a bit of oil, I add a batch of meatballs and let them sear until golden on all sides. Then I lower heat and let them cook through (to an internal temperature of ~165°F). I remove them to a plate and repeat with the rest.
Using the same skillet (with a bit of cleaning or residual oil), I melt ghee and olive oil, then sauté onion until soft. I add garlic and sage, then stir in Italian seasoning. Next I pour in pumpkin puree, chicken stock, salt, pepper, then whisk in Parmesan, heavy cream, maple syrup, and fresh sage. I simmer until it thickens.
I return the cooked meatballs to the sauce and gently stir to coat. I let them simmer in the sauce for a few minutes so the flavors meld and the meatballs heat fully.