Spiralize the zucchini: Use a spiralizer or a julienne peeler to make noodles. Lay them on a clean towel, sprinkle lightly with salt, and let them sit while you cook. This helps reduce excess moisture.

Mix the meatballs: In a bowl, combine ground meat, Parmesan, egg, almond flour (if using), parsley, garlic, onion powder, salt, and pepper. Mix gently with your hands until just combined. Do not overmix or the meatballs can turn dense.

Form and sear: Roll into 1 to 1.5-inch meatballs. Heat olive oil in a large skillet over medium heat. Sear meatballs on all sides until browned, about 6–8 minutes total. They don’t need to be fully cooked through yet.

Build the sauce base: Reduce heat to medium-low. Add pesto, heavy cream, and broth (if using) to the skillet. Stir to combine, scraping up browned bits. Add lemon zest, a little lemon juice, and garlic if using. Simmer gently 3–4 minutes.

Finish cooking the meatballs: Nestle the meatballs into the sauce. Cover and simmer 5–8 minutes, or until they reach an internal temp of 165°F (74°C) for poultry or 160°F (71°C) for beef/pork. Adjust salt, pepper, and red pepper flakes.

Sauté the zoodles: In a separate large pan, heat olive oil or butter over medium. Pat the salted zucchini dry, then cook 1–2 minutes, tossing just until warmed and slightly tender. Do not overcook; they release water quickly.

Combine and serve: Add the zoodles to the skillet with the sauce and meatballs, or plate the zoodles and spoon the creamy pesto meatballs over the top. Finish with extra Parmesan and herbs. Add a squeeze more lemon if desired.