In a large skillet or Dutch oven, heat over medium-high heat. Add ground beef and cook until browned, about 5–7 minutes. Drain excess grease.

Add finely chopped yellow onion to the skillet and sauté for 3–4 minutes until soft. Stir in minced garlic and cook for 30 seconds.

Pour in tomato sauce and beef broth. Stir in Worcestershire sauce, salt, black pepper, and dried Italian herbs if using. Mix well.

Add uncooked elbow macaroni to the skillet, stirring to combine thoroughly. Cover the skillet.

Reduce heat to medium-low and simmer covered for 12–15 minutes, stirring occasionally until pasta is tender.

Once pasta is cooked, reduce heat to low. Stir in milk and shredded cheddar cheese until melted and creamy.

Taste and adjust seasonings if necessary. Serve warm, garnishing with parsley or additional cheese.