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Warm the olive oil in a large frying-pan over a low-medium heat. Cook the onion with a pinch of salt until softened and just beginning to colour (8-10 minutes), stirring occasionally.
Increase the heat to medium-high and add the sausage meat. Using the back of a wooden spoon, break the meat up into small pieces and cook until nicely coloured (3-4 minutes). Deglaze the pan with the wine and simmer for a few minutes. Once the liquid has reduced a little, pour in the cream and stir to combine. Add the nutmeg, reduce the heat to low-medium and simmer until the sauce has thickened (8-10 minutes). Season to taste.
While the sauce is simmering, cook the pasta in a pot of salted, boiling water until just before al dente. Use a slotted spoon to scoop out the pasta and transfer it directly into the pan with the sauce; stir to coat. Add a ladleful of pasta cooking water to the pan and increase the heat to medium-high. Simmer for 2-3 minutes or until the pasta is al dente, adding more pasta water, as needed, to ensure the sauce doesn't dry out and stays nice and silky.
Serve with a generous grating of pecorino.
*For the pasta itself, I prefer a short pasta like rigatoni, but penne and tortiglioni also work well
Tip: When in season, fresh truffles are shaved on top of this dish, but it's equally lovely without them.