Start by bringing a large pot of salted water to a boil. Add 8 ounces of elbow macaroni and cook according to the package directions until al dente, about 7-8 minutes. Drain well and set aside.
Heat 2 tablespoons of olive oil in a large skillet over medium heat. Add 1 chopped onion and sauté until translucent, about 3-4 minutes. Stir in 2 cloves of minced garlic and cook for another minute until fragrant. Add 1 pound of ground turkey and cook, breaking it up with a spoon, until browned and fully cooked through.
Season the cooked turkey with 1 teaspoon salt, 1/2 teaspoon black pepper, 1/2 teaspoon paprika, and 1/2 teaspoon cayenne pepper. Pour in 1 cup of buffalo sauce and stir well to coat the meat evenly. Let it simmer for 2-3 minutes to meld the flavors.
Reduce the heat to low and add 1 cup of softened cream cheese to the skillet. Stir until melted and incorporated into the sauce. Then, add 1 cup shredded cheddar cheese and 1 cup shredded mozzarella cheese, stirring constantly until the cheese melts into a smooth, creamy sauce.
Transfer the cooked macaroni to a large mixing bowl. Pour the buffalo cheese and turkey mixture over the pasta and fold gently until everything is evenly combined.
Preheat your oven to 350°F (175°C). Lightly grease a 9x13-inch baking dish and spread the macaroni mixture evenly in the dish. Bake for 20-25 minutes until the casserole is bubbly and the top is lightly golden.
Remove from the oven and sprinkle 1/4 cup sliced green onions over the top for a fresh pop of color and flavor. Serve hot and enjoy every comforting, spicy bite!