Cook The Garlic. Melt the butter in a small skillet or saucepan over medium-low heat. Add the minced garlic and cook for 30 to 60 seconds, stirring constantly. The garlic should smell fragrant but should not turn dark brown.
Blend The Cottage Cheese. Add the cottage cheese, milk, Parmesan, cooked garlic and butter, black pepper, nutmeg, and Italian seasoning to a blender. Blend until completely smooth. Stop and scrape down the sides if any curds or cheese remain visible.
Check The Consistency. The sauce should be thick but pourable. Add additional milk one tablespoon at a time if it is too thick. Remember that it will loosen slightly as it warms and may be thinned further with pasta water.
Warm The Sauce. Pour the blended sauce into the saucepan. Warm it over low heat for 3 to 5 minutes, stirring constantly. Do not let it boil. Remove it from the heat as soon as it is smooth, warm, and slightly thickened.
Taste And Adjust. Taste the sauce before adding salt. Add more black pepper, Parmesan, garlic, or a small pinch of salt if needed.
Serve. Toss the sauce with warm pasta, chicken, vegetables, zucchini noodles, or spaghetti squash. If using pasta, add reserved pasta water one tablespoon at a time until the sauce coats the noodles evenly.