Bring a large pot of water to a boil, adding in 1 tsp salt. Once your water is boiling add your cubed butternut squash and cook until soft and fork tender.
Carefully remove the cooked squash and place it in a blender and blend until smooth.
In a large non-stick pan brown your sage sausage over medium-high heat, purposefully breaking up the sausage as you cook it. When completely cooked set your sausage aside for later.
Lower the temperature on your pan to medium-low heat and melt your butter. Sauté your onion and garlic until cooked through. Add back in your blended butternut squash, chicken broth, heavy cream, nutmeg, and Parmesan cheese. Stir to combine and bring to a slow simmer.
Next, add in your sausage and cooked pasta and carefully mix everything together.
Serve warm topped with shredded Parmesan cheese and fresh sage leaves.