In a large mixing bowl, combine soaked breadcrumbs, ground turkey, minced onion, garlic, fresh sage, Italian seasoning, eggs, and parmesan. Mix gently but thoroughly without overworking.

Shape the turkey mixture into evenly sized meatballs, about 1 to 1.5 inches in diameter, and place them on a parchment-lined baking sheet.

Heat a splash of olive oil in a skillet over medium-high heat. Add the meatballs and cook for 5-7 minutes until golden-brown on all sides.

In a separate saucepan, combine the canned pumpkin puree, heavy cream, fresh sage, salt, and pepper. Heat over medium, stirring until warmed through.

Gently add the browned meatballs into the simmering pumpkin sage sauce and allow to simmer for 5 minutes, turning occasionally.

Plate the meatballs drizzled with the sauce and garnish with extra sage or parmesan. Serve warm.