you can use zabbix template module to manage templates, if you want to automate everything then you should try to not use items without templates, just add those items to templates, make as much templates you need, and then link host to needed templates.
we have much templates, and we have create in defaults/main.yml ansible group mapping to zabbix group mapping (as we have lots ansible groups, we don't want to add them to zabbix all) also there is defined dict with default templates, and when some group needs to add more templates, you just merge those dict's and that way you can manage ansible. don't know what you need more :)
in a way you can make your modules if youre interested in extending functionality.