01 - Bring a large pot of salted water to a rolling boil. Add the fettuccine or spaghetti and cook according to package directions until al dente. Reserve 1/2 cup of the starchy pasta water before draining.
02 - While the pasta cooks, melt the butter with olive oil in a large skillet over medium heat. Add the thinly sliced onions and sprinkle with sugar and salt to encourage browning.
03 - Cook the onions, stirring frequently, for 25 to 30 minutes until they turn a deep golden brown and become richly caramelized. If the onions begin to stick to the pan, add a splash of water to deglaze and continue cooking.
04 - Stir in the minced garlic and cook for 1 minute until fragrant, being careful not to let it brown.
05 - Reduce the heat to low and pour in the heavy cream and whole milk, stirring to combine. Add the grated Parmesan cheese, black pepper, and nutmeg if using. Simmer gently for 2 to 3 minutes until the sauce thickens slightly. Season with salt to taste.
06 - Add the drained pasta to the skillet and toss thoroughly to coat every strand. Add the reserved pasta water a splash at a time until the sauce reaches a silky, creamy consistency that clings to the noodles.
07 - Transfer to warmed plates immediately. Garnish with chopped fresh parsley and an extra shower of grated Parmesan before serving.