Set Instant Pot on "Saute" mode and heat until hot. Add sausage. Brown and crumble until cooked through.
Add tomatoes, garlic, basil, salt and water to the sausage and stir to combine.
Pour pasta into the sauce, but do not stir. Instead, gently submerge the pasta into the sauce with the back of a spatula so that most of the pasta is covered as best you can.
Lock Instant Pot lid in place making sure the venting valve is sealed.
Cook on high pressure for 5 minutes.
While the pasta is cooking make the white sauce by melting the butter in a medium-sized saucepan on the stove. When melted, stir the flour into the butter and cook for 1 minute, stirring until smooth.
Slowly stir the milk into the pan, stirring until no lumps remain. Cook, stirring frequently, until the sauce is thickened. Remove from the heat and stir in the salt and nutmeg. Set aside.
When the cooking time for the pasta is up, carefully release the venting valve to do a quick pressure release. When the pressure pin drops, remove the lid.
Gently stir the white sauce into the pasta until evenly combined. Spread the shredded mozzarella over the pasta and replace the lid just until the cheese is melted.
Serve hot with garlic bread and a salad.