Differentiable Neural Architecture Search (NAS) provides a promising avenue for automating the complex design of deep learning (DL) models. However, current differentiable NAS methods often face constraints in efficiency, operation selection, and adaptability under varying resource limitations. We introduce ZO-DARTS++, a novel NAS method that effectively balances performance and resource constraints. By integrating a zeroth-order approximation for efficient gradient handling, employing a sparsemax function with temperature annealing for clearer and more interpretable architecture distributions, and adopting a size-variable search scheme for generating compact yet accurate architectures, ZO-DARTS++ establishes a new balance between model complexity and performance. In extensive tests on medical imaging datasets, ZO-DARTS++ improves the average accuracy by up to 1.8\% over standard DARTS-based methods and shortens search time by approximately 38.6\%. Additionally, its resource-constrained variants can reduce the number of parameters by more than 35\% while maintaining competitive accuracy levels. Thus, ZO-DARTS++ offers a versatile and efficient framework for generating high-quality, resource-aware DL models suitable for real-world medical applications.