How to check application's health api in private ec2 with No NAT Gateway.

I can think of a couple of ways of doing this but they all boil down to (more or less) the same thing:

Have a Lambda function running on the private subnet to do the health check (that you already have); and then use a VPC Endpoint for another AWS service to send the results out from that Lambda function. You could use SNS or SQS (both of which could trigger another Lambda function directly); or you could use CloudWatch Synthetics.

Note that the VPC endpoint does introduce additional cost (but then, so does NAT Gateway) but it restricts the access from the private subnet to the service that you've created the endpoint for. You can also use an endpoint policy to further restrict access if you like.