Prep your base. If using zoodles, lightly salt and set in a colander to release moisture. If using shirataki noodles, rinse well and dry in a skillet for 2–3 minutes. If using cauliflower rice or shredded cabbage, par-cook until just tender and set aside.

Brown the beef. Heat olive oil in a large skillet over medium-high heat. Add the ground beef, breaking it up with a spatula. Season with salt, pepper, and half the Italian seasoning. Cook until browned with some crispy edges, 6–8 minutes.

Sauté aromatics. If using onion, push the beef to the edges and add a small pat of butter to the center. Sauté onion until translucent, 2–3 minutes. Add garlic and cook 30 seconds until fragrant. Stir everything together.

Deglaze. Pour in beef broth and scrape up any browned bits from the pan. Let it simmer for 1–2 minutes to reduce slightly.

Build the Alfredo base. Reduce heat to medium-low. Add remaining butter and heavy cream. Stir in cream cheese if using. Let the mixture gently bubble, stirring, until smooth and slightly thickened, 3–5 minutes. Avoid boiling.

Add the cheese. Sprinkle in Parmesan a handful at a time, stirring constantly until melted and velvety. Season with the rest of the Italian seasoning, red pepper flakes if you like heat, and more salt and pepper to taste.

Combine with your base. Add your prepared low-carb base (zoodles, shirataki, cauliflower rice, or cabbage) to the skillet. Toss gently until everything is coated and warmed through. If the sauce is too thick, splash in a bit more cream or broth.

Finish and serve. Turn off heat. Adjust seasoning, add a squeeze of lemon for brightness if desired, then top with chopped parsley. Serve hot with extra Parmesan on the side.