Guy is just asking for chicken carbonara with no bacon and the server keeps telling him it isn't possible.
Then this lady gets super incensed and starts going off calling everyone that disagrees with her "medigan" which is apparently a derogatory term used by Italian Americans to insult people they think have "lost touch with their Italian heritage"
The comments and replies are 
CW obviously discussions of and images of meat https://xcancel.com/sandinistaoliva/status/1952374193275756572
as others have said, it's from The Sopranos, a critically acclaimed and popular Very Dark Comedy that ran from 1999-2007 ostensibly about the leader of a crime family (biological and extended).
it's tone ranges from goofy to grim, sometimes in the same moment. the result was a very quoteable show with a massive audience that remember and experienced it differently.