As noted in the licensing FAQ (https://docs.microsoft.com/en-us/sccm/core/understand/product-and-licensing-faq) and more specifically in the comments (https://github.com/MicrosoftDocs/SCCMdocs/issues/464) the SQL Server license included with ConfigMgr does not allow hosting databases for solutions commonly integrated with ConfigMgr.

This is a request to include rights to use relevant Microsoft / 1st party products (MDT, MBAM, PowerBI integrated with ConfigMgr) and 3rd party solutions which have the exclusive purpose of maintaining a healthy ConfigMgr environment (CMMonitor / Ola Hallagren's SQL Server Maintenance Solution, Anders Rodland's ConfigMgr Client Health solution, etc.) in the SQL usage rights that are included with ConfigMgr.

Microsoft solutions which do not integrate with ConfigMgr, and ConfigMgr related 3rd party solutions (1E Nomad/ActiveEfficiency, Adaptiva OneSite, etc.) whose purpose is to extend functionality, not simply maintain ConfigMgr, would continue to be excluded from usage rights.

From an ConfigMgr administrative perspective, it makes no sense to require SQL Express or an additional SQL server license to use solutions (Ola's and Anders) whose sole purpose is to address SQL/ConfigMgr issues (performance / client health). Additionally, it just makes sense to use the same SQL instance for Microsoft solutions which integrate with ConfigMgr.