Preheat your oven to 350°F and lightly grease an 11x7-inch baking dish with butter or cooking spray.
Bring a large pot of salted water to a boil over medium-high heat. Add the macaroni and cook according to the package directions. Drain and set aside.
In a large saucepan, melt 3 tbsp butter over medium heat. Once melted, add the flour and whisk together until smooth. Cook for 1 minute, stirring constantly.
Gradually add the milk, whisking constantly to prevent lumps. Bring the mixture to a low simmer and cook for 3 minutes or the until slightly thickened.
Remove the pan from heat and add the nutmeg, salt, mozzarella cheese, asiago cheese, fontina cheese, cheddar cheese, and Romano cheese. Whisk together until all ingredients are combined and the cheese is completely melted.
Pour the macaroni into the prepared baking dish and pour the cheese sauce over top. Stir to combine everything together then top with cubed french bread.
In a small bowl, mix together the remaining butter, truffle oil, Italian seasoning, and minced garlic until combined. Drizzle the butter mixture over the top of the macaroni.
Bake for 30 minutes or until golden brown and bubbly. Serve warm.