Boil the tortellini. Bring a large pot of salted water to a boil.
Cook tortellini according to package directions until just tender. Reserve 1/2 cup of pasta water, then drain and set aside.
Start the sauce base. In a large skillet, heat butter and olive oil over medium heat. Add minced garlic and cook for 30–60 seconds, stirring, until fragrant but not browned.
Deglaze with wine. Pour in the white wine and let it simmer for 1–2 minutes, scraping up any bits from the pan.
If skipping wine, add an extra splash of broth instead.
Add cream and broth. Stir in the heavy cream and broth. Bring to a gentle simmer. Keep the heat at medium-low so the sauce doesn’t boil vigorously.
Season and thicken. Add a pinch of nutmeg, red pepper flakes if using, and a small pinch of salt and pepper.
Simmer 2–3 minutes to slightly thicken.
Stir in Parmesan. Reduce heat to low. Gradually whisk in the grated Parmesan, a handful at a time, until melted and smooth. If the sauce seems too thick, loosen with a splash of pasta water.
Finish with lemon. Add lemon zest and 1–2 teaspoons of lemon juice.
Taste and adjust salt and pepper. The sauce should taste rich, savory, and bright.
Toss with tortellini. Add the cooked tortellini to the skillet and gently fold to coat. If adding spinach or peas, stir them in now and warm through for 1–2 minutes.
Garnish and serve. Top with chopped parsley or basil and extra Parmesan.
Serve hot with a crack of black pepper.