Preheat oven to 425°F (220°C). Toss butternut squash cubes with 1 tbsp olive oil, salt, and pepper. Spread on a baking sheet and roast 20–25 minutes, turning once, until golden and tender.

Bring a large pot of salted water to a boil and cook pasta until 1 minute shy of al dente. Reserve 1/2 cup pasta water, drain pasta, and set aside.

In a large skillet over medium-high heat, add remaining 1 tbsp olive oil. Crumble and cook the sausage until browned, about 6–8 minutes.

Push sausage to the side and add chopped onion to the skillet. Cook until softened, then add garlic and sage and cook 30 seconds until fragrant.

Pour in wine or broth to deglaze the pan, scraping up browned bits. Reduce by half, then stir in cream and butter. Simmer 2–3 minutes and whisk in Parmesan until smooth.

Add roasted squash and cooked pasta to the skillet, tossing gently to coat. If sauce is too thick, loosen with reserved pasta water. Adjust salt and pepper.

Top with chopped parsley or sage and extra Parmesan. Serve immediately while warm and silky.