Aeotec Z-stick 5+ - how to backup NVM? From within HA or do I need Node.js on desktop?

HA doesn’t support NVM backup. You’ll need to switch to Z-Wave JS UI to do that. Here’s a guide:

Note that restoring a NVM backup from an Aeotec Z-Stick to a 700 or 800 series requires the Z-Stick be on firmware v1.2 (AKA 1.02). Z-Stick Gen5+ V1.02 firmware update : Aeotec Help Desk

IMO, unless you already have one, I’d skip the Aeotec Z-Stick 7 and go with a Zooz or HomeSeer 800-series controller. Or if you can wait a few months, go with the Nabu Casa controller when it’s released.