In a large skillet, heat olive oil over medium heat. Add the diced onion and garlic, cooking until fragrant and the onion is translucent, about 3-4 minutes.

Add the Italian sausage to the skillet, breaking it up with a spoon. Cook until browned and cooked through, about 5-7 minutes.

Stir in the diced red bell pepper and cook for an additional 2-3 minutes until softened.

Add the cauliflower rice to the skillet along with the Italian seasoning, paprika, salt, and black pepper. Mix well to combine.

Cook the mixture, stirring occasionally, for about 5-7 minutes until the cauliflower rice is tender and heated through.

Taste and adjust seasoning if necessary. Remove from heat.

Serve hot, garnished with chopped parsley and grated Parmesan cheese if desired.