Bring a large pot of salted water to a boil and cook the pasta according to package instructions until al dente.
Reserve 0.5 cup of pasta cooking water, then drain the pasta and set aside.
In a high-speed blender, combine the cottage cheese, grated parmesan, milk, salt, pepper, and nutmeg; blend on high until the mixture is completely smooth and no curds remain.
Heat the olive oil in a large skillet over medium heat; add the minced garlic and sauté for approximately 1 minute until fragrant but not browned.
Reduce the skillet heat to low and pour in the blended cottage cheese mixture.
Whisk the sauce constantly for 2 to 3 minutes until heated through, ensuring the sauce does not reach a rolling boil to prevent curdling.
Add the cooked pasta to the skillet and toss to coat thoroughly.
Adjust the consistency by adding the reserved pasta water 1 tablespoon at a time until the sauce reaches the desired thickness.
Serve immediately, garnished with additional black pepper if desired.