Shred the cheddar cheese and set it aside to ensure it melts smoothly later on in the cooking process.

Season the ground beef with salt and pepper, then cook it over medium heat in a large pot along with diced onions until browned, breaking it apart as it cooks.

Once the beef has browned, add minced garlic to the pot and cook for one additional minute before introducing Worcestershire sauce and tomato paste, stirring until everything is well combined.

Pour in beef broth and stir in the uncooked macaroni, bringing the mixture to a gentle simmer over medium heat while ensuring everything is evenly mixed.

Cover the pot and let it cook for five minutes; then uncover, stir briefly, replace the lid, and let it cook for another five minutes or until the macaroni reaches an al dente texture.

Reduce heat to low and stir in room temperature sour cream along with half of the milk; gradually mix in shredded cheddar until melted before topping with remaining cheese for an extra cheesy finish.