Cook the pasta in salted water until al dente. Reserve 1 cup of the pasta water before draining.
Melt butter in a skillet over medium heat. Add garlic and cook 30 seconds until fragrant.
Add cream, sriracha, and honey. Simmer 3 to 4 minutes until slightly thickened.
Stir in Parmesan until smooth. Taste and adjust seasoning.
Add the pasta to the skillet and toss, adding reserved pasta water as needed.
Remove from heat and gently fold in the flaked tuna.
Divide into bowls, top with scallions or cilantro, and serve with lime wedges.