In a bowl add ground beef, egg, onion and garlic mixture, Italian seasonings and smoked paprika and mix until everything is well combined. Roll the meat into balls.
Heat a large skillet over medium-high heat and add the avocado or olive oil. Let the oil to heat up before adding the meatballs. Add the meatballs and sear on all sides and until they're cooked through and remove from the skillet.
To the same skillet add the butter and let it melt. Once melted add the spinach and cook for 30 seconds to a minute then add the water, half and half and orzo. Bring to a boil over high heat and cook the orzo. Stir occasional and cook for about 8-10 minutes or follow the package instructions. Add the crushed red pepper flakes and add the meatballs back into the skillet.