Add the elbow macaroni, water, and salt to the Instant Pot. Secure the lid, set the valve to sealing, and cook on High Pressure for 4 minutes. Once the cooking time is complete, perform a quick release.
Switch the Instant Pot to Saute mode. Stir in the milk and butter until the butter is fully melted and the mixture is smooth and creamy.
Gradually add the shredded cheddar and mozzarella cheese, stirring continuously until the cheese is fully melted and the sauce becomes rich and velvety.
Stir in the harissa paste and smoked paprika. Season with salt and black pepper to taste, adjusting the spice level if needed.
Turn off Sauté mode and let the mac and cheese sit for 2–3 minutes to thicken slightly.
Serve warm, garnished with a sprinkle of smoked paprika or fresh herbs if desired.