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Heat olive oil in a large pan over medium heat.
Add the onion and cook for about 3 minutes, until softened.
Add the garlic and cook briefly until fragrant.
Add the ground beef, oregano, chili flakes, salt, and pepper. Cook until well browned, breaking it apart as it cooks.
Stir in the tomato paste and cook for 1–2 minutes.
Add the crushed tomatoes and optional carrot.
Pour in the cream, add the optional nutmeg, and gently simmer for 10–15 minutes until thickened.
Reduce the heat and stir in the Parmesan.
Toss with the cooked pasta, adding a splash of pasta water if needed.
Finish with extra Parmesan and serve warm.