A lot of Italian food rules tend to be more regional than most italians think. Even the classic heretical example of spaghetti and meatballs pretty closely resembles traditional dishes from Abruzzo - https://www.lacucinaitaliana.it/ricetta/primi/spaghetti-alla...
Agreed on the regional rules and the spaghetti and meatballs might indeed be related to the dish you mention. However, while you _can_ have spaghetti and meatballs in the "Italian food grammar", people from Abruzzo might be even more horrified by the American dish: 1) their meatballs are small enough to be part of the sauce. You don't have to tear them apart 2) the pasta remains the base of the dish rather than a kind of side 3) you would never serve "plain" pasta with the sauce and meatballs on top [1], the sauce and to some extent the meatballs would be well mixed with the pasta before it reaches the table.
So it's not the concept of spaghetti and meatballs, but rather the way ingredients are balanced and presented.
For sure, I'm definitely not claiming they're the same dish, absolutely the concept of spaghetti and meatballs has evolved from whatever it's original origins were.
I guess my overall point is that I think the author is overstating the strictness of these rules, even in famously rigid traditions like Italy. Changing food around as it is shared and moves between cultures isn't a uniquely American or even modern thing, it's been happening for ages and a whole lot of traditional foods have been heavily influenced by other cultures.
Also super nitpicky but most folks in north america would incorporate the sauce in spaghetti and meatballs before serving, the whole sauce on top thing is mostly relegated to grandparents and betty crocker recipes - I'm sure a not small part of the reason for that is people rediscovering italian techniques though.
Highly recommended Youtube channel, by the way. It's just Italian grandmas making amazing food full of love, kneading pasta by hand and generally being delightful.
Plenty of dishes combining pasta and meat, also in the cookbook that was published in 2019. So I figure the article was trying to hint that the presentation of US-style spaghetti and meatballs is what would upset Italians. The meatballs should be marble-sized.
