Preheat a skillet over medium-high heat. Grate about half of your onion using the second-smallest holes of a box grater.
Measure two tablespoons of the grated onion, leaving behind any liquid.
Combine ground turkey, Worcestershire sauce, onion, salt, and pepper (if using) in a large mixing bowl.
Mix the ingredients well, trying not to overwork the turkey meat too much.
Divide the turkey into four equal patties.
Add the patties to the hot skillet and cook for about 4 minutes on each side or until an instant-read thermometer measures an internal temperature of 165 degrees Fahrenheit.
If adding cheese, add it in the last two minutes of cooking.
Remove the patties from the pan. Let cool for a minute or two before adding to the lettuce.
Build the lettuce wraps by placing a patty on a lettuce leaf and placing another lettuce leaf over top. Add your favorite toppings and serve right away!