McDonald's might be the largest restaurant chain in Italy but that doesn't really mean much given how many small restaurants the country has with high quality food.
There is a reason those Italians live so long. Their McDonalds is better than others. It is literally illegal to sell McDonalds foods the way Americans make it.
They aren’t high end chefs. They are normal workers that aren’t squeezed by their company to produce food in the cheapest way
You should see what they do in the UK. Looks tasty, but healthy it certainly is not.