Cook the Macaroni: In a large pot, cook elbow macaroni according to package instructions. Drain and set aside.
Prepare the Bacon: In a skillet over medium heat, cook the bacon until crispy. Remove from the skillet and drain on paper towels. Crumble into small pieces.
Cook the Beef: In the same skillet, cook the ground beef over medium-high heat until browned. Drain excess fat if necessary.
Combine Ingredients: Add diced onion to the beef and cook until softened. Stir in ketchup, mustard, Worcestershire sauce, salt, and pepper. Cook for 2 minutes.
Mix in Cheese and Macaroni: Add shredded cheddar cheese to the beef mixture, stirring until melted and combined. Then, mix in the cooked macaroni and crumbled bacon.
Assemble the Wraps: Lay out the flour tortillas on a flat surface. Divide the beef and macaroni mixture evenly among the tortillas. Top with shredded lettuce, tomato slices, and pickles if using.
Wrap and Serve: Roll up the tortillas tightly to enclose the filling. Slice in half diagonally and serve warm.