They clearly do self-test on startup; not of the car, of the computer, i.e., after the battery is reconnected. Then they do some dynamic learning, establishing the behaviors they need to best control the particular engine in the particular vehicle, and storing them until power is removed. That was as of ten years ago. Flash makes some of the learning unnecessary, or allows a better starting point.
Common procedures for programming flash memory include readback and comparison, usually within the programming device, to make sure the program 'stuck'. All invisible to a technician.
It's not easy for an embedded computer to isolate a hardware failure on its own, or for a human programmer to tell it how to do so. I don't think any of them run a background bit-check routine, because it would bulk up the program for miniscule returns. I.e., if cosmic rays mess up something external to the diagnostic code, they're just as likely to mess up the diagnostic code itself. That level of self- diagnostics is part of how the Shuttle wound up with seven identical computers to do the work that one car computer could do.
Instead, it appears that car computers are constantly running sanity checks on what they can measure. In some cases they just 'send up a flare' when something doesn't make sense. In other cases, given what is now decades of collective experience, they can infer what's going on by measuring stuff that's nominally unrelated. One good example; car computers can detect a loose gas cap, but they don't have transducers specifically for that purpose. Instead, they do some shenanigans with venting and closing the vapor emission control devices, and measure the time it takes for some switch or other to change state in response. I'm fuzzy on the details, but Google can probably find a writeup on it.
Now, if a technician is telling you that he needs to run a diagnostic test on your computer... well, he may be just trying to pay for the expensive tester he bought. Odds are that the problem is somewhere other than in the car computer, but the process of connecting the tester and running the test may clear up the problem, or cause it to become bad enough to diagnose by other means, or may cause the tech to look under the correct rock.
No, I'm not saying the tech is ripping you off. If a test costs less than replacing the computer, and makes your problem go away, then whatever its intrinsic worth, it was a good test.
Mike Halloran
Pembroke Pines, FL, USA