Preheat the oven to 400°F (200°C). Toss the cubed butternut squash with olive oil, salt, and pepper. Spread on a baking sheet and roast for 25-30 minutes until tender and caramelized.

In a large pot, bring salted water to a boil. Add the fusilli pasta and cook according to package instructions until al dente. Drain and set aside.

In a skillet over medium heat, add a little olive oil and sauté the minced garlic until fragrant. Add the heavy cream, Parmesan cheese, chopped sage, salt, and pepper. Stir until the cheese is melted and the sauce is smooth.

Add the roasted butternut squash and cooked pasta to the cream sauce. Toss gently to combine. Serve warm, garnished with additional Parmesan and sage if desired.