Cook the fettuccine according to the package instructions in a large pot of boiling, salted water. Once cooked, reserve about 1 cup of the pasta water before draining.
While the pasta is cooking, melt the butter in a large skillet or saucepan over medium heat. Add the cream and bring to a simmer. Reduce the heat to low.
Gradually add 1 cup of the grated Parmesan cheese to the cream and butter mixture, constantly stirring until the cheese is fully melted and the sauce is smooth.
Add salt, black pepper, and a pinch of nutmeg to the sauce. Stir well.
Once the pasta is cooked and drained, add it to the sauce in the skillet. Toss until the pasta is fully coated in the sauce. If needed, add some of the reserved pasta water to loosen the sauce and make it creamier.
Remove from heat and mix in the remaining 1/2 cup of Parmesan cheese.
Garnish with chopped fresh parsley, if desired, and serve immediately.
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