Heat the skillet over medium-high heat. Add ground beef and diced onion, breaking up the meat as it cooks for about 5-7 minutes until browned. Drain excess fat, leaving about 1 teaspoon.
Add minced garlic to the meat mixture and cook for 30 seconds until fragrant. Stir in the seasoning blend and Worcestershire sauce (if using), and cook until aromatic.
Pour in beef broth, whole milk, and tomato sauce, scraping up browned bits from the pan. Stir in the elbow macaroni and ensure it's submerged.
Bring to a boil, then reduce heat to medium-low and cover. Simmer for 10-12 minutes, stirring occasionally to prevent sticking.
Remove from heat and stir in shredded cheddar cheese in batches until melted, adding cream cheese if using for extra creaminess.
Taste and adjust seasoning before serving immediately, garnished with parsley if desired.