Place a large deep-sided skillet over medium heat. Add oil to skillet.
Once oil is hot, saute ginger and garlic for 30 seconds to 1 minute until fragrant.
Add soy sauce, almond butter, honey, rice vinegar, sesame oil, and red pepper flakes to skillet. Stir until almond butter has melted and sauce is smooth. (It will look broken for a little, don't worry.)
Pour water into sauce and stir until peanut sauce has thinned. Pour in pasta and stir. Bring sauce to a simmer.
Cover skillet and reduce heat to medium-low. Simmer pasta for 12 to 15 minutes, or until pasta is al dente and sauce has thickened. Stir the pasta every 3 minutes or so to make sure the sauce doesn't burn. Check the seasoning and add salt and pepper to taste.
While pasta is cooking, place two veggie patties on a plate and microwave according to package directions. Chop into small pieces. Add patties to pasta once finished cooking and stir to coat in sauce.
If serving family style, top pasta with garnish now. Otherwise, portion pasta into serving bowls. Top with carrots, cilantro, green onion, and peanuts. Serve warm.
Since we're using almond butter, you can absolutely swap chopped peanut fro chopped almonds if you prefer. Peanuts are the more traditional option.
This recipe yields 2 large servings of pasta or 3 moderate portions.