1tablespoonsage finely chopped (small leaves can be left whole)
salt and pepper to taste
Cook pasta according to package directions. Drain pasta but reserve 1/2 cup of pasta water.
Meanwhile, melt the butter in a saute pan and add onion. Cook on medium heat until onions are translucent. Add the pumpkin puree, milk (or cream), nutmeg, and Parmesan in a saute pan and whisk to combine. Season with salt and pepper.
Slowly add the reserved pasta water to thin out the sauce to desired consistency if needed and add the drained pasta, stirring to coat evenly. Top with sage and additional Parmesan cheese, if desired.