Preheat your oven to 400°F (200°C). Toss the cubed butternut squash with olive oil, salt, and pepper on a baking sheet. Spread it evenly and roast for about 25-30 minutes until tender and caramelized.

While the squash is roasting, bring a large pot of salted water to a boil. Add your chosen pasta and cook according to package instructions until al dente. Drain the pasta but reserve about 1 cup of pasta water.

In a large skillet over medium heat, cook the Italian sausage until browned and fully cooked, breaking it apart with a spatula. Remove from the skillet and set aside.

Using the same skillet, sauté minced garlic until fragrant, about 1 minute.

Pour in the chicken broth and bring it to a gentle simmer. Add the roasted butternut squash and blend until smooth.

Stir in the heavy cream, chopped spinach, ground sage, and dried thyme. Allow to simmer until spinach wilts and the sauce thickens slightly.

Combine the cooked sausage and drained pasta into the sauce, mixing until all pieces are well-coated. Adjust consistency with reserved pasta water if necessary.

Stir in grated Parmesan cheese until melted and combined. Adjust seasoning with salt, pepper, and red pepper flakes if using.

Serve hot, garnished with additional Parmesan cheese.