Begin by chopping both ends of the butternut squash and removing the bulb. You can save the bulb for another recipe. With the neck only, peel the skin and spiralize. Cut all the noodles into desirable lengths.
Toss noodles in oil. Spread evenly on sheet pan lines with parchment paper and lightly salt. Cook for 25- 30 minutes. Toss halfway through with a pair of tongs.
While noodles are cooking, heat a large pan over medium heat. Add sausage. Brown and break up. Continue to cook until there is no more pink. Remove sausage from the pan and set aside.
Finely dice ¼ cup of onion and add to the pan with the sausage fat. Lower the heat slightly. Cook until the onion begins to caramelize.
Peel and mince the garlic. Add to the pan with the onion and allow to cook for about 1 minute.
Add the cream and almond milk to the pan and whisk together. **See notes on making a richer sauce.
Add the grated cheese and finely chopped basil. Let everything heat up while stirring. Add the spices and salt to taste if needed.
Using the tongs, add the butternut squash noodles to the pan. Toss in the sauce.
Add the sausage and toss. Grate extra parmesan cheese on top if desired. Serve immediately.
To make a richer cream sauce, you can use all cream or substitute the almond milk and heavy cream for half and half. Another option would be to add 1-2 tablespoons of butter when you add the cream. I would recommend considering one of these options if using using zucchini noodles which are more watery than butternut squash.