In a saucepan, whisk together ketchup, vinegar, honey, hot sauce (if using), brown sugar, Worcestershire, and mustard. Next, stir in smoked paprika, garlic powder, onion powder, cayenne, salt, and pepper.
Add meatballs and bring to a simmer over medium-low heat. Cook 10–15 minutes, stirring occasionally, until thickened and glossy and meatballs reach an internal temp. of 165 degrees Once the sauce has reduced and meatballs are heated through, turn off the heat and add in the butter, stirring until melted.
Serve with garlic toast!
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