Heat a large skillet over medium-high heat. Add the lean ground beef and chopped onion, breaking the beef into small crumbles as it cooks until the meat is no longer pink, about 5 to 7 minutes; drain excess fat if needed.

Add the minced garlic to the browned beef and onion. Stir constantly and cook for about 30 seconds, just until the garlic smells fragrant without allowing it to burn.

Stir in the undrained diced tomatoes, tomato sauce, water, Italian seasoning, salt, and black pepper. Scrape the bottom of the skillet to loosen any flavorful browned bits.

Bring the tomato mixture to a boil over medium-high heat. Stir occasionally so the sauce heats evenly before adding the pasta.

Stir in the uncooked elbow macaroni, then reduce the heat to a gentle simmer and cover the skillet. Cook for about 10 to 12 minutes, stirring every few minutes so the macaroni does not stick to the bottom.

Check that the pasta is tender and remove the skillet from the heat. Let the goulash stand for a few minutes so the sauce can thicken before serving.