Ensure you use a large 6 quart slow cooker for this recipe.

Pour tomato sauce into the slow cooker.

Add olive oil to the sauce.

Add whole garlic cloves to the sauce.

Add hot pepper relish (optional) to the sauce.

Add Italian seasoning to the sauce.

Stir all ingredients in the slow cooker well.

Cut the spaghetti squash in half.

Scoop out the seeds from both squash halves.

Place the squash halves face down into the slow cooker, submerging them in the sauce.

Roll the ground Italian sausage into meatballs.

Arrange the meatballs in the sauce around the squash halves.

Cook on High for 3 hours or cook on Low for 5 hours.

Once cooked, use a large fork to pull the spaghetti squash strands out of the squash shells.

Top the spaghetti squash with the meatballs and sauce.

Garnish with parsley before serving.