The ethnicity results are not comparable to your family tree because the largely predate the genetic time period (last several hundred years.) They are based on slowly mutating markers that may in fact date back thousands of years, so the Middle East could reflect the migration west of early farming groups that displaced hunter-gatherer populations in Europe. Also, Italy was a crossroads of many civilizations for millennia so some complex results are not surprising.
This if from the Ancestry FAQ:
Your genetic ethnicity results go back hundreds of years
In some cases, the markers in your DNA may reveal ethnicities that go back hundreds, or even a thousand years. This could differ from what you have documented in your family tree. So keep in mind that there may be some ethnic differences in your more recent family history as compared to generations ago.
People and borders move
The past few thousand years were very dynamic and the constant historical movements and changes defined the people and places that we know around the world today. Because people move over time, (and when they do they take their DNA with them), a group may contribute DNA to other groups at different times. Because of this, ethnic groups can be defined by time and place—not just location. For example, if you have German or British ancestors in your family tree, it’s a possibility that your genetic ethnicity may be partly Scandinavian. The Viking invasions and conquests about a thousand years ago are likely responsible for occurrences of Scandinavian ethnicity throughout other regions. And there are similar examples for other ethnicities.
Between DNA inheritance and other factors, there is always the possibility of a difference between what your results show and what your research would lead you to expect. Consider: all your ancestors have their own mixes of ethnic information, and they may or may not pass every detail to the next generation. It is possible that some ethnicity may be lost due to either lack of detectability or lack of transfer from parent to child.