01 - Combine ground turkey, grated Parmesan, almond flour, egg, minced garlic, parsley, oregano, salt, and pepper in a large bowl. Mix until ingredients are just incorporated, being careful not to overwork the mixture.
02 - With lightly damp hands to prevent sticking, shape the turkey mixture into 16 uniform small meatballs, approximately 1.5 inches in diameter for even cooking.
03 - Heat 1 tablespoon olive oil in a large skillet over medium heat. Add meatballs in batches without overcrowding the pan. Cook for 10 to 12 minutes, turning occasionally, until golden brown on all sides and completely cooked through with an internal temperature of 165°F. Remove and set aside on a plate.
04 - Place basil leaves, Parmesan, pine nuts, garlic, lemon juice, salt, and pepper in a food processor. Pulse until finely chopped. With the motor running, gradually drizzle in olive oil until the mixture reaches a smooth, emulsified consistency. Taste and adjust seasoning as needed.
05 - Wipe out the skillet and add 1 tablespoon olive oil. Add spiralized zucchini noodles and sauté over medium-high heat for 2 to 3 minutes, tossing frequently with tongs, until just tender-crisp. Season with salt and pepper to taste.
06 - Add prepared pesto to the zucchini noodles and toss thoroughly to coat evenly. Divide among serving plates and top with turkey meatballs. Garnish with additional grated Parmesan and fresh basil leaves if desired. Serve immediately while warm.