I include a proof for the original question. It is between the first two pictures.
There are infinitely many solutions with both $x,y \leq 0.$ This comes under the heading of Vieta Jumping. Given a solution to $x^2 - 4xy + y^2 + y = 0,$ we can create new solutions by alternately taking mappings on the hyperbola,
$$ (x,y) \mapsto (x, 4x-y - 1) \; \; \; , $$
$$ (x,y) \mapsto (4x-y,y) \; \; \; . $$
The solutions on the hyperbola branch that is (mostly) in the third quadrant begin
$$ (0,0); \; (0,-1); \; (-4,-1); \; (-4,-16); \; (-60,-16); \; (-60,-225); \; \ldots $$
There are infinitely many rational solutions with both $x,y > 0.$
$$ \left(\frac{1}{2},\frac{1}{2}\right); \; \; \left(\frac{3}{2},\frac{1}{2}\right); \; \; \left(\frac{3}{2},\frac{9}{2}\right); \; \; \left(\frac{33}{2},\frac{9}{2}\right); \; \; \left(\frac{33}{2},\frac{121}{2}\right); \; \; \left(\frac{451}{2},\frac{121}{2}\right); \; \; \left(\frac{451}{2},\frac{1681}{2}\right); \; \; \ldots $$
The $y$ values above are of the form $\frac{b_n^2}{2},$ where $b_{n+2} = 4 b_{n+1} - b_n \; , \;$ giving $1,3,11,41,153,571,...$
If there were any integer solutions in the first quadrant, these same mappings would take us to an integer solution with both $x,y$ fairly small obeying certain explicit inequalities.

The following diagram goes with the inequality part:
If there were an integer solution with $x,y > 0$ and $x+y \geq 10,$ we are going to show that one of the mappings given reduces $x+y$ by at least two; therefore a finite number of steps would take us to an integer solution with $x,y > 0$ and $x+y < 10.$ One can quickly inspect and find that there are no integer solutions with such small numbers. So that is it.
If $x+y \geq 10$ and both positive, one case, closer to the positive $x$ axis, has $x > y$ and $y > 2.$ From the quadratic formula and the inequalities we find $x = 2y + \sqrt{3y^2 - y}.$ Note that $3y^2 - y > 1.$ At this point, we have $x+y = 3y + \sqrt{3y^2 - y}.$ Now, after we apply the mapping $ \color{magenta}{ (x,y) \mapsto (4x-y,y) \; \; \; }, $ the replacement value for $x+y$ is $3y - \sqrt{3y^2 - y},$ so it has shrunk by at least $2.$
The second case is closer to the positive $y$ axis, $y > x$ and $x > 2.$ We find $y = \frac{4x-1 + \sqrt{12x^2 - 8x+1}}{2}.$ After applying the other mapping $ \color{magenta}{ (x,y) \mapsto (x,4x-1-y) \; \; \; }, $ The new $y$ value is $y = \frac{4x-1 - \sqrt{12x^2 - 8x+1}}{2}.$ Therefore the sum we keep calling $x+y$ has decreased by $\sqrt{12x^2 - 8x+1}$ which is larger than $2$ when $x > 2.$ Again, we have shrunken $x+y$ by at least $2.$
That's it. There cannot be any integer solutions with $x,y > 0$ because there are none with $x+y \leq 10.$
$$ \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc \bigcirc $$

I found out how to draw line segments in desmos. One can put in a short table of points and have it connect them in order. Here is the hyperbola in the first quadrant, showing the first four of the half integer points and how a stairway connects them, beginning an infinite process. The next point on this staircase, which goes up and to the right, would be $\left(\frac{33}{2},\frac{121}{2}\right);$

Alright, here is the hyperbola with the first few points in the third quadrant that have integer coordinates, joined up with green line segments, beginning with the origin and $(0,-1).$ The next point in this downward stairway would be $(-60,-16)$
