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Preheat the oven to 350F and grease a 9x13 inch glass or ceramic baking dish.
In a large skillet over medium high heat, cook the sausage until browned and cooked through, breaking up any clumps with the back of a wooden spoon.
In a large bowl, whisk together the eggs, cream, and garlic. Stir in the shredded zucchini (no need to drain it!).
Add the coconut flour, baking powder, salt, pepper, and red pepper flakes and stir until well combined and there are no lumps from the flour. Stir in the sausage.
Spread the mixture in the prepared baking pan and sprinkle the top with the cheese. Bake 40 to 45 minutes, until golden brown. A tester inserted in the center should come out clean.
Remove and let cool 10 minutes before serving.