The conditions are that either $(a<0\land b<0)$ or $(a>0\land b>0)$. If the former, then $$\begin{cases}a<0\\ b<0\\ a+b+2\sqrt{ab}=2(b-a)\end{cases}\Leftrightarrow\begin{cases}a<0\\ b<0\\-(\sqrt{-a}-\sqrt{-b})^2=2(\sqrt{-a}-\sqrt{-b})(\sqrt{-a}+\sqrt{-b})\end{cases}\Leftrightarrow\\\Leftrightarrow\begin{cases}a<0\\ b<0\\(\sqrt{-a}-\sqrt{-b})(3\sqrt{-a}+\sqrt{-b})=0\end{cases}\Leftrightarrow \begin{cases}a<0\\ b<0\\ a=b\end{cases}\lor\begin{cases}a<0\\ b<0\\ \sqrt{-b}=-3\sqrt{-a}\end{cases}\Leftrightarrow\begin{cases}a<0\\ a=b\end{cases}$$
If they are both positive, $$\begin{cases}a>0\\ b>0\\ a+b+2\sqrt{ab}=2(b-a)\end{cases}\Leftrightarrow\begin{cases}a>0\\ b>0\\ (\sqrt a+\sqrt b)^2-2(\sqrt b-\sqrt a)(\sqrt a+\sqrt b)=0\end{cases}\Leftrightarrow\\\Leftrightarrow\begin{cases}a>0\\ b>0\\ (\sqrt a+\sqrt b)(3\sqrt a-\sqrt b)=0\end{cases}\Leftrightarrow\begin{cases}a>0\\ b>0\\ \sqrt a=-\sqrt b\lor 3\sqrt a=\sqrt b\end{cases}\Leftrightarrow\\\Leftrightarrow \begin{cases}a>0\\ b>0\\ b=9a\end{cases}$$
So, for non-zero real numbers the identity holds if and only if either $b=a<0$ or $b=9a>0$.
$$\begin{align} (-a) + (-b) -2\sqrt{(-a)(-b)} &= 2[(-b)-(-a)]\ \left(\sqrt{-b} - \sqrt{-a}\right)^2 &= 2\left(\sqrt{-b}+\sqrt{-a}\right)\left(\sqrt{-b} - \sqrt{-a}\right) \end{align}$$
Then $\left(\sqrt{-b} - \sqrt{-a}\right)$ may be zero and cannot be simply rejected.
– peterwhy Jan 25 '21 at 12:57$$\begin{align} \frac{2\sqrt{ab}}{a} = \frac{2\sqrt{ab}}{-|a|} = \frac{2\sqrt{ab}}{-\sqrt{a^2}} = -2\sqrt{\frac{b}{a}} \end{align}$$
– peterwhy Jan 25 '21 at 13:06