diff --git a/consul/assets/configuration/spec.yaml b/consul/assets/configuration/spec.yaml
index b43df67b44145..d9a2721d562e9 100644
--- a/consul/assets/configuration/spec.yaml
+++ b/consul/assets/configuration/spec.yaml
@@ -157,6 +157,27 @@ files:
         display_default: false
         example: true
 
+    - name: health_checks_cache_size
+      fleet_configurable: true
+      description: |
+        Maximum number of health check entries kept in the cache used to detect status
+        transitions. Increase this if your Consul cluster reports more than 5000 distinct
+        health checks across nodes. Evicted entries cause status transitions to be missed
+        and failure events to be re-emitted on subsequent check runs.
+      value:
+        type: integer
+        example: 5000
+        minimum: 1
+
+    - name: health_checks_cache_ttl
+      fleet_configurable: true
+      description: |
+        Time-to-live in seconds for entries in the health check status cache.
+      value:
+        type: integer
+        example: 3600
+        minimum: 1
+
     - template: instances/http
     - template: instances/default
   - template: logs
diff --git a/consul/changelog.d/23603.added b/consul/changelog.d/23603.added
new file mode 100644
index 0000000000000..fa7b7820e07bb
--- /dev/null
+++ b/consul/changelog.d/23603.added
@@ -0,0 +1 @@
+Make the health check status cache size and TTL configurable via ``health_checks_cache_size`` and ``health_checks_cache_ttl``.
\ No newline at end of file
diff --git a/consul/datadog_checks/consul/common.py b/consul/datadog_checks/consul/common.py
index bd3d9f78be898..9ae36d1bc8288 100644
--- a/consul/datadog_checks/consul/common.py
+++ b/consul/datadog_checks/consul/common.py
@@ -24,6 +24,10 @@
 # Increase the number of threads to collect consul services checks
 THREADS_COUNT = 1
 
+# Defaults for the in-memory cache used to detect health check status transitions
+HEALTH_CHECKS_CACHE_SIZE = 5000
+HEALTH_CHECKS_CACHE_TTL = 3600
+
 STATUS_SC = {
     'up': AgentCheck.OK,
     'passing': AgentCheck.OK,
diff --git a/consul/datadog_checks/consul/config_models/defaults.py b/consul/datadog_checks/consul/config_models/defaults.py
index 97798a85f9c69..8366ca94f0602 100644
--- a/consul/datadog_checks/consul/config_models/defaults.py
+++ b/consul/datadog_checks/consul/config_models/defaults.py
@@ -48,6 +48,14 @@ def instance_enable_legacy_tags_normalization():
     return True
 
 
+def instance_health_checks_cache_size():
+    return 5000
+
+
+def instance_health_checks_cache_ttl():
+    return 3600
+
+
 def instance_kerberos_auth():
     return 'disabled'
 
diff --git a/consul/datadog_checks/consul/config_models/instance.py b/consul/datadog_checks/consul/config_models/instance.py
index 8d8be33d6d249..5f65a49cb7088 100644
--- a/consul/datadog_checks/consul/config_models/instance.py
+++ b/consul/datadog_checks/consul/config_models/instance.py
@@ -12,7 +12,7 @@
 from types import MappingProxyType
 from typing import Any, Optional
 
-from pydantic import BaseModel, ConfigDict, field_validator, model_validator
+from pydantic import BaseModel, ConfigDict, Field, field_validator, model_validator
 from typing_extensions import Literal
 
 from datadog_checks.base.utils.functions import identity
@@ -76,6 +76,8 @@ class InstanceConfig(BaseModel):
     enable_legacy_tags_normalization: Optional[bool] = None
     extra_headers: Optional[MappingProxyType[str, Any]] = None
     headers: Optional[MappingProxyType[str, Any]] = None
+    health_checks_cache_size: Optional[int] = Field(None, ge=1)
+    health_checks_cache_ttl: Optional[int] = Field(None, ge=1)
     kerberos_auth: Optional[Literal['required', 'optional', 'disabled']] = None
     kerberos_cache: Optional[str] = None
     kerberos_delegate: Optional[bool] = None
diff --git a/consul/datadog_checks/consul/consul.py b/consul/datadog_checks/consul/consul.py
index eb33aa991a396..1501e2b5a48ef 100644
--- a/consul/datadog_checks/consul/consul.py
+++ b/consul/datadog_checks/consul/consul.py
@@ -24,6 +24,8 @@
     CONSUL_CHECK,
     HEALTH_CHECK,
     HEALTH_CHECK_METRIC,
+    HEALTH_CHECKS_CACHE_SIZE,
+    HEALTH_CHECKS_CACHE_TTL,
     MAX_CONFIG_TTL,
     MAX_SERVICES,
     SOURCE_TYPE_NAME,
@@ -133,7 +135,15 @@ def __init__(self, name, init_config, instances):
         if 'acl_token' in self.instance:
             self.http.options['headers']['X-Consul-Token'] = self.instance['acl_token']
 
-        self.health_checks = TTLCache(ttl=3600, maxsize=5000)
+        cache_size = self.instance.get(
+            'health_checks_cache_size',
+            self.init_config.get('health_checks_cache_size', HEALTH_CHECKS_CACHE_SIZE),
+        )
+        cache_ttl = self.instance.get(
+            'health_checks_cache_ttl',
+            self.init_config.get('health_checks_cache_ttl', HEALTH_CHECKS_CACHE_TTL),
+        )
+        self.health_checks = TTLCache(ttl=cache_ttl, maxsize=cache_size)
 
     def _is_dogstatsd_configured(self):
         """Check if the agent has a consul dogstatsd profile configured"""
diff --git a/consul/datadog_checks/consul/data/conf.yaml.example b/consul/datadog_checks/consul/data/conf.yaml.example
index 547288a234296..13b918baca614 100644
--- a/consul/datadog_checks/consul/data/conf.yaml.example
+++ b/consul/datadog_checks/consul/data/conf.yaml.example
@@ -147,6 +147,19 @@ instances:
     #
     # collect_health_checks: true
 
+    ## @param health_checks_cache_size - integer - optional - default: 5000
+    ## Maximum number of health check entries kept in the cache used to detect status
+    ## transitions. Increase this if your Consul cluster reports more than 5000 distinct
+    ## health checks across nodes. Evicted entries cause status transitions to be missed
+    ## and failure events to be re-emitted on subsequent check runs.
+    #
+    # health_checks_cache_size: 5000
+
+    ## @param health_checks_cache_ttl - integer - optional - default: 3600
+    ## Time-to-live in seconds for entries in the health check status cache.
+    #
+    # health_checks_cache_ttl: 3600
+
     ## @param proxy - mapping - optional
     ## This overrides the `proxy` setting in `init_config`.
     ##
diff --git a/consul/tests/test_unit.py b/consul/tests/test_unit.py
index 2b844e3601da8..f7dd1bc797608 100644
--- a/consul/tests/test_unit.py
+++ b/consul/tests/test_unit.py
@@ -671,3 +671,41 @@ def test_config(test_case, extra_config, expected_http_kwargs, mocker):
         }
         http_wargs.update(expected_http_kwargs)
         mock_session.get.assert_called_with('/v1/status/leader', **http_wargs)
+
+
+def test_health_checks_cache_defaults():
+    consul_check = ConsulCheck(common.CHECK_NAME, {}, [consul_mocks.MOCK_CONFIG])
+    assert consul_check.health_checks.maxsize == 5000
+    assert consul_check.health_checks.ttl == 3600
+
+
+def test_health_checks_cache_configurable():
+    config = dict(consul_mocks.MOCK_CONFIG)
+    config['health_checks_cache_size'] = 10
+    config['health_checks_cache_ttl'] = 60
+    consul_check = ConsulCheck(common.CHECK_NAME, {}, [config])
+    assert consul_check.health_checks.maxsize == 10
+    assert consul_check.health_checks.ttl == 60
+
+
+def test_health_checks_cache_configurable_via_init_config():
+    init_config = {'health_checks_cache_size': 42, 'health_checks_cache_ttl': 7}
+    consul_check = ConsulCheck(common.CHECK_NAME, init_config, [consul_mocks.MOCK_CONFIG])
+    assert consul_check.health_checks.maxsize == 42
+    assert consul_check.health_checks.ttl == 7
+
+
+def test_health_checks_cache_eviction_re_emits_failure_event(aggregator):
+    config = dict(consul_mocks.MOCK_CONFIG_DISABLE_SERVICE_TAG)
+    config['collect_health_checks'] = True
+    config['health_checks_cache_size'] = 1
+    consul_check = ConsulCheck(common.CHECK_NAME, {}, [config])
+    my_mocks = consul_mocks._get_consul_mocks()
+    my_mocks['consul_request'] = consul_mocks.mock_get_health_check
+    consul_mocks.mock_check(consul_check, my_mocks)
+
+    consul_check.check(None)
+    consul_check.check(None)
+
+    failure_events = [e for e in aggregator.events if e['event_type'] == 'consul.check_failed']
+    assert len(failure_events) == 2
diff --git a/postgres/changelog.d/23647.fixed b/postgres/changelog.d/23647.fixed
new file mode 100644
index 0000000000000..2b40d45842aa9
--- /dev/null
+++ b/postgres/changelog.d/23647.fixed
@@ -0,0 +1 @@
+Eliminate reference cycle in diagnostic instrumentation
\ No newline at end of file
diff --git a/postgres/datadog_checks/postgres/diagnose.py b/postgres/datadog_checks/postgres/diagnose.py
index 9044799e911f7..7520e0f34c185 100644
--- a/postgres/datadog_checks/postgres/diagnose.py
+++ b/postgres/datadog_checks/postgres/diagnose.py
@@ -32,6 +32,11 @@
 RECOMMENDED_TRACK_ACTIVITY_QUERY_SIZE = 4096
 
 
+def run_diagnostics(check):
+    """Entry point for ``Diagnosis.register()``; creates a short-lived worker per invocation."""
+    PostgresDiagnose(check)._run()
+
+
 class PostgresDiagnose:
     """Explicit pre-flight diagnostics for `datadog-agent diagnose`."""
 
@@ -42,21 +47,6 @@ def __init__(self, check):
         # when shared_preload_libraries is empty). Reset at the top of the first orchestrator.
         self._failed = set()
 
-    # -- registration ---------------------------------------------------------
-
-    def register(self):
-        """Register the diagnostic entry point with the check's Diagnosis object.
-
-        Idempotent: re-invoking `register` on the same Diagnosis object is a no-op.
-        ``Diagnosis.register`` extends an internal list, so without this guard a
-        repeated call would stack the entry point and produce N× the diagnostics.
-        """
-        d = self._check.diagnosis
-        if getattr(d, '_postgres_diagnostics_registered', False):
-            return
-        d._postgres_diagnostics_registered = True
-        d.register(self._run)
-
     # -- orchestrator ---------------------------------------------------------
 
     def _run(self):
diff --git a/postgres/datadog_checks/postgres/postgres.py b/postgres/datadog_checks/postgres/postgres.py
index 113e4402af133..0d9223662d657 100644
--- a/postgres/datadog_checks/postgres/postgres.py
+++ b/postgres/datadog_checks/postgres/postgres.py
@@ -47,7 +47,7 @@
 
 from .__about__ import __version__
 from .config import build_config, sanitize
-from .diagnose import PostgresDiagnose
+from .diagnose import run_diagnostics
 from .util import (
     ANALYZE_PROGRESS_METRICS,
     AWS_RDS_HOSTNAME_SUFFIX,
@@ -191,8 +191,7 @@ def __init__(self, name, init_config, instances):
             ttl=self._config.database_instance_collection_interval,
         )  # type: TTLCache
 
-        # Register explicit pre-flight diagnostics for `datadog-agent diagnose`.
-        PostgresDiagnose(self).register()
+        self.diagnosis.register(functools.partial(run_diagnostics, self))
 
     def _submit_initialization_health_event(self):
         try: