Add the ground beef to a skillet that has been heated to medium heat. Add the onion, and crumble until browned. Drain any excess fat.
Add in the garlic and add salt and pepper to taste. Saute until fragrant, or for about 1 minute. Remove from the heat and set aside.
Add the marinara sauce, water, half of the pepperoni slices, chopped fresh basil (if using) and 1 cup of the shredded mozzarella cheese to the slow cooker. Stir well.
Add the pasta, and stir to combine. Push the noodles below the liquids. This will help the pasta cook through, without too many crunchy bits. The more submerged the pasta, the butter the result.
Add the ground beef and onion mixture into the crock pot.
Add the remaining mozzarella cheese, Top the mixture in the crockpot with the remaining mozzarella cheese and pepperoni slices.
Cook on low for 3 hours, then test the noodles to see if they are tender and cooked through. If not, replace the lid and cook for an additional 1 hour for a total of 4 hours.
Garnish with the parmesan cheese, and additional chopped basil or parsley if desired. Serve and enjoy!