Boil salted water in a large pot, add gnocchi, and cook for 2-3 minutes until they float. Drain, reserving ½ cup pasta water.

In a skillet, heat olive oil over medium heat. Sauté diced onion for 5-7 minutes. Add minced garlic and cook for another minute.

Pour in pumpkin puree and heavy cream, stirring to combine. Add Parmesan cheese, simmer for 5 minutes. Season with nutmeg, salt, and pepper.

Stir in spinach until wilted, then fold in cooked gnocchi. Adjust sauce thickness with reserved pasta water as needed.

Serve in bowls, garnished with extra Parmesan and red pepper flakes, paired with crusty bread.