Cook the Ground Beef: In a large pot or Dutch oven, brown the ground beef over medium heat. Drain any excess fat. Add the chopped onion and cook for about 3-4 minutes until softened. Stir in the minced garlic and cook for another minute until fragrant.

Add Broth and Pasta: Pour in the beef broth and bring to a boil. Add the macaroni pasta and cook according to package instructions, usually about 7-8 minutes, until al dente.

Stir in Remaining Ingredients: Once the pasta is cooked, stir in the diced tomatoes (with their juices), milk, Worcestershire sauce, Italian seasoning, and shredded cheddar cheese. Cook for an additional 2-3 minutes, stirring until the cheese is melted and everything is heated through.

Season and Serve: Taste and season with salt and black pepper as needed. Serve hot, garnished with extra cheese and optional toppings like chopped green onions, croutons, or bacon bits.