Possible Obfuscation / Abuse
It appears that someone has taken the article from a manageable <40 command line entries and 6K bytes to 20K bytes, and now command line entries that number 100-200+: https://wiki.alpinelinux.org/w/index.php?title=Zabbix&type=revision&diff=19688&oldid=17984
Can Mckaygerhard justify the need for this additional complexity, or is this obfuscation? It looks like the latter. It is written with spelling errors/rushed, has non-idiomatic use of sed (# instead of / dividers), and lists non existent links like alpine newbie lamers, and refers to zabbix as a curse. It's also much more LOC.
Consider that I tested the old guide, and it works fine (v3.14) except that I had to copy the zabbix.conf.php from a different zabbix install to this since the database type doesn't populate during the setup.php install (essentially bypassing it). And the js on the web console only worked with certain browsers.
Given that the old guide will suffice for the majority of users, I suggest the old one is reinstated, and Mckagerhard's additions can be left as a second option for those interested in more details. The old guide uses fastcgi, and postgres. Mckagerhard's guide uses cgi, and mysql. Since they are distinct guides, they can be kept separate.