Preheat oven to 400 degrees. Prepare a parchment paper-lined sheet pan.
In a large bowl, combine ground beef, egg, almond flour, minced sage, ginger, salt, pepper and granulated garlic until well combined. Scoop into 1-inch meatballs then roll between hands. Set aside on sheet pan while you fry sage leaves.
In a large lipped saute pan over medium high heat, add olive oil and let warm a couple minutes. Add the sage leaves and let sizzle until bubbling and lightly crisp, about 2 minutes per side. Set aside on a paper towel to drain.
To the same hot pan, add the meatballs in single layer and brown on all sides, about 1-2 minutes per side. You may need to do this in batches- turn heat down if meatballs are getting too dark. Return browned meatballs to sheet pan and bake until completely cooked through, 10-12 minutes.
Wipe most of the fat out of the saute pan, leaving a teaspoon or so to form the sauce. Over medium heat, add coconut aminos and the orange juice and zest. Let simmer, scraping any brown bits from the bottom of the pan, 2-3 minutes.
Stir in remaining ingredients and simmer, whisking well, for 4-5 minutes. When meatballs are finished, add them to the bubbling sauce, tossing to coat. Transfer to serving platter and top with fried sage leaves. Enjoy!