Cook macaroni according to package directions. Drain well and place in a large bowl.
While macaroni is still hot, sprinkle on vinegar. Add carrot and onion. Toss together until well combined. Refrigerate for 15 minutes, or until cooled.
In a separate, small bowl, whisk together mayo, milk, and sugar. Fold the mayo mixture into the macaroni until all the noodles are evenly coated. Add salt and pepper to taste.
Cover and refrigerate for at least 4 hours (best if overnight). Gently stir before serving, add a little more milk if needed, no more than a tablespoon or two.