Cook the sausage. Place a large skillet over medium heat. Add the ground sausage, breaking it up into small pieces with a spatula or spoon, until it is browned and cooked thoroughly. This should take about 5-7 minutes. Once the sausage is cooked, use a slotted spoon to remove it from the pan, allowing any excess fat to drain, and transfer it to a plate. Set it aside.

Cook the Onion and garlic. In the same pan with the remaining sausage fat, add the diced onion and minced garlic. Sauté them over low heat until they become softened and translucent. This should take about 3-4 minutes.

Add in the almond flour. Sprinkle the almond flour over the onion and garlic mixture and add the butter. Whisk everything together and allow it to simmer for about 2 minutes. This will help thicken the gravy.

Add the cream and seasoning. Pour in the heavy cream and season with salt and pepper to taste. Stir the mixture thoroughly to combine all the ingredients.

Finish off the creamy gravy. Increase the heat slightly to bring the mixture to a gentle boil, stirring occasionally. Once it starts boiling, reduce the heat to low and let the gravy simmer for about 1 minute. This will allow the flavors to meld. Return the cooked sausage to the pan with the gravy. Stir everything together and let it cook for another minute or so, ensuring the sausage is evenly coated with the gravy. If you prefer a thinner gravy, you can gradually add 1 tablespoon of water at a time until it reaches your desired consistency. Stir well after each addition to ensure it is mixed evenly.