Preheat oven to 350°F and line a baking sheet with parchment. Set aside.
Add eggplant to a medium pot of boiling water and cook until a fork can easily pierce the eggplant, about 8-10 minutes. Drain eggplant well. Either squeeze out the eggplant in a clean kitchen towel or press out the eggplant in a strainer to remove excess liquid.
Transfer eggplant to a bowl and add in the garlic, almond flour, parmesan cheese (if using), egg, olive oil and spices. Mix well.
Using a cookie scoop or a spoon, scoop out about 2 tablespoons of mixture and gently form into a bowl. The mixture is soft, but can easily be shaped. If you are having trouble achieving the shape, add in 1 tablespoon more of almond flour at a time until you can easily make a meatball shape with it.
Bake in the preheated oven for 20 minutes, or until tender and firm to touch.
Meanwhile, make the sauce: heat oil and garlic in a medium pot. Add in onion and let cook for 2 minutes, stirring often. Add in remaining sauce ingredients, and bring to a boil. Once boiling reduce heat and let simmer for 10-15 minutes. Taste and adjust seasoning.
Gently toss together the meatballs and the sauce, and serve over noodles of choice.