Cook macaroni pasta according to package directions. Drain, set aside.
In the same pot you cooked the macaroni, melt 2 tablespoons butter in a skillet over medium heat.
Cook and stir garlic in melted butter until lightly browned, about 5 minutes.
Whisk the flour into the butter and garlic to form a smooth paste.
Slowly add the evaporated milk whisking into flour mixture until it forms a smooth sauce; simmer until thickened, 2 to 4 minutes.
Add in the shredded cheese and cream cheese and whisk and stir until completely melted, about 5 minutes.
Add the rest of the ingredients except the sausage and and stir until combined.
Lightly stir in the smoked sausage and the cooked macaroni until heated through, about 5 minutes.
Serve hot, enjoy!
Bake in the preheated oven until topping is brown and crisp, 40 minutes.