Brown ground beef with garlic in a large skillet over medium heat, breaking up meat as it cooks.
Drain grease once beef is fully browned.
Add browned beef to slow cooker with crushed tomatoes, tomato sauce, beef broth, red wine, cheddar cheese, onion, bell pepper, Worcestershire sauce, tomato paste, paprika, Italian seasoning, and salt.
Stir to combine.
Cover and cook on low for 6 hours.
Stir in uncooked elbow macaroni during the final hour of cooking.
Once pasta is tender, taste and adjust salt as needed.
Serve topped with extra shredded cheese and fresh parsley if desired.