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Heat a large (12-inch) nonstick skillet over medium-high heat. Add 1 tablespoon olive oil, then the meatballs. Cook, turning frequently, until even golden brown and heated through the center, 8 to 10 minutes total. Remove from skillet to a paper towel-lined plate. Once skillet is cool enough to handle, wipe clean with paper towel.
Return skillet to medium heat. Add 1 teaspoon olive oil, tomatoes, and ½ teaspoon salt. Cook for 2 to 3 minutes, until slightly golden and just tender (but not burst). Remove to a plate.
Add the remaining 1 teaspoon olive oil, then zucchini noodles. Season with remaining ½ teaspoon salt and stir very gently to combine. Cook, stirring occasionally, for about 3 minutes or until zoodles are slightly tender. Add the pesto and stir gently to combine.
Transfer to a large serving platter and top with meatballs, tomatoes, roasted almonds, and Parmesan cheese, if desired. Serve immediately.