Heat olive oil in a large skillet over medium heat. Add the onion and garlic, and sauté for about 5 minutes, stirring often, until fragrant and translucent.
Add the chicken sausage to the pan and cook for 5-6 minutes, stirring occasionally, until it develops a golden-brown crust.
Stir in the orzo, tossing for about a minute to lightly toast, then pour in the chicken broth, coconut milk, Italian seasoning, salt, and pepper.
Bring the mixture to a gentle boil, then reduce the heat to low, cover, and simmer for 10-12 minutes. Stir occasionally to ensure the orzo doesn’t stick, cooking until it’s tender but al dente.
Add the baby spinach and parmesan cheese, stirring until the spinach wilts and the cheese melts seamlessly into the dish.
Serve hot, garnished with crushed red pepper, fresh basil, and extra parmesan if desired.