In a large bowl, combine turkey, grated zucchini, almond flour, onion, garlic, egg, ketchup, Worcestershire, Italian seasoning, paprika, salt, and pepper. Mix gently until just combined—do not overmix to keep them tender.
1 lb ground turkey, 1 cup zucchini, ½ cup almond flour, 1 small onion, 2 cloves garlic, 1 large egg, 2 tbsp ketchup, 1 tbsp Worcestershire sauce, 1 tsp dried Italian seasoning, ½ tsp smoked paprika, ½ tsp salt, ¼ tsp black pepper