Step 1: Cook the onion and sausage together in a skillet, breaking the sausage apart until no longer pink; drain and pour into crock-pot.
Step 2: Add the garlic, bell pepper, pepperoni, mushroom, olives, pasta sauce, kidney beans, parmesan cheese, oregano, salt and hot pepper flakes if using; cook over high heat for 4 hours.
Step 3: Ladle into bowls and top with cheese.
Step 4: Enjoy!
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