Wash and chop the fresh spinach, then set it aside. Dice the medium onion and finely mince the garlic cloves.

In a large pot, bring salted water to a rolling boil. Add the gnocchi and boil for 2-3 minutes until they float. Drain and reserve ½ cup of pasta water.

In a large skillet, warm the olive oil over medium heat. Add the diced onion and sauté for 5-7 minutes, then add minced garlic for another minute.

Pour in the pumpkin puree and heavy cream, stir well. Add Parmesan cheese, nutmeg, salt, and pepper. Simmer for about 5 minutes.

Incorporate the chopped spinach into the sauce, stir until it wilts down.

Fold the cooked gnocchi into the creamy sauce. Add reserved pasta water if the sauce is too thick.

Plate the dish, garnishing with extra Parmesan cheese and red pepper flakes if desired.