Heat a 4-5 quart pot or Dutch oven over medium heat. Add ground beef, diced onion, and minced garlic. Cook for 6-8 minutes, breaking up the beef with a wooden spoon until completely browned with no pink remaining and onions are soft and translucent. If using regular ground beef with higher fat content, drain excess fat, leaving about 1 tablespoon in the pot.

Pour in tomato sauce, 2 cups of beef broth, and sprinkle in Italian seasoning. Stir to combine, then add elbow macaroni, stirring to ensure most pasta is covered by liquid. Bring to a gentle boil, then reduce heat to maintain a steady simmer.

Cover the pot and simmer for 15-17 minutes, stirring every 3-4 minutes to prevent sticking. The pasta will absorb the liquid and become tender. If mixture looks too dry, add an extra ½ cup of broth and cook 2-3 minutes longer. Pasta is done when no hard center remains when you bite into it.

Remove from heat. If using cheese, sprinkle over the top and stir until melted throughout. Let rest for 2-3 minutes before serving to allow sauce to thicken. Taste and adjust seasoning with salt and pepper as needed.