In a large pot over medium-high heat, melt the lard. Add the onion, carrots, garlic, dried oregano, 1 tsp salt, and freshly ground pepper to taste. Cook, stirring, until soft, about 5 minutes. Remove from pot and put into a large bowl.
Add the ground turkey thighs, almond flour, eggs, sage, the remaining salt and approx 1/2 tsp freshly ground black pepper to the bowl and mix with your hands. Form the mixture into meatballs, about the size of golf balls.
In the same pot you cooked the onion/carrot mixture in, add the tomatoes, garlic, dried basil, olive oil, and salt and pepper to taste. Mix and cook over medium-high heat until boiling.
Add the meatballs to the sauce and turn the heat down to a simmer. Simmer for 30 minutes.
Serve over sweet potato noodles, spaghetti squash, or mashed cauliflower.