Bring a large pot of salted water to a boil. Add the elbow macaroni and cook according to package directions, about 8-10 minutes, or until al dente.
Once cooked, drain the macaroni in a colander and rinse under cold water to cool it down. Allow it to drain thoroughly.
In a mixing bowl, combine the mayonnaise, apple cider vinegar, and sugar. Whisk until smooth and well blended.
Add the cooled macaroni to the mixing bowl, along with the diced celery, diced bell pepper, diced onion, sweet pickle relish, salt, and black pepper.
Stir everything together until the macaroni and vegetables are evenly coated with the dressing.
Taste and adjust seasoning if necessary.
Transfer the macaroni salad to a refrigerator-safe serving bowl and cover it with plastic wrap or a lid.
Chill in the refrigerator for at least 1 hour (or up to overnight) to allow the flavors to meld together.
If desired, garnish with chopped hard-boiled eggs before serving.