You can add servers in the VPC where the load balancer is created, in a different VPC, or in an on-premise data center, by using private IP addresses of the servers. In this way, incoming traffic can be flexibly distributed to cloud servers and on-premises servers for hybrid load balancing.
Ensure that the IP addresses of the servers are reachable and the backend ports are actually used by backend servers. Otherwise, the backend servers will be considered unhealthy.