The primitive element theorem dictates there is an $c$ such that $\mathbb Q(a,b)=\mathbb Q(c)$, but $c=a+b$ may not work. For example, $$\mathbb Q(\sqrt 2, \sqrt 3) = \mathbb Q(\sqrt 2 + \sqrt 3, \sqrt 2 - \sqrt 3)\not=\mathbb Q(2\sqrt 2)=\mathbb Q(\sqrt 2)$$
Let $a=\sqrt{1+2i}, b=\sqrt{1-2i}$. In this case, there are some ambigurity of which square-roots we are taking, but at least we can find one pair such that $\bar a = b$, therefore $a+b$ is real, hence cannot generate $\mathbb Q(a,b)$.
"but any isomorphism of this kind seems to be the conjugation"
Do you mean "complex conjugation"? This is also unjustified. The splitting field of an irreducible polynomial of degree $4$ would have Galois group of order at least $4$ (and at most $4!=24$). The Galois action is transitive for the roots of an irreducible polynomial.
Now we figure out the Galois group. So $\mathbb Q(a,b)$ contains $a^2$ hence $i$, as well as $ab=\sqrt{5}$. Therefore it contains a subextension $\mathbb Q(i, \sqrt 5)$ of degree $4$. It's also easy to show that $\mathbb Q(a,b)$ is also the splitting field of $p(x)=x^4-4x^2-16$ by checking $\pm a\pm b$ are all roots of the polynomial. We have $p(x)$ is irreducible, because otherwise, its Galois group is of degree $2$ or $3$ or $3!$, but none of them has a factor $4$. But since $p(x)$ has a pair of real roots, while $i\in\mathbb Q(a,b)$, we know that the splitting field is not simply $\mathbb Q$ joined by a single root, but more roots are needed.
Let $\alpha = \sqrt{2+2\sqrt 5}$ be a real root of $p(x)$. Now we claim the splitting field of $p(x)$ is just $\mathbb Q(\alpha, i)$ whose degree is $[\mathbb Q(\alpha, i):\mathbb Q]=[\mathbb Q(\alpha)(i):\mathbb Q(\alpha)][\mathbb Q(\alpha):\mathbb Q] = 8$. This is easy since the other roots are $-\alpha$ and $\beta = i\sqrt{2\sqrt 5 - 2}, -\beta$ which satisfies $\alpha\beta = 4i$. Therefore $\beta\in\mathbb Q(\alpha, i)$.
Now it's pretty clear that $\operatorname{Gal}(F/\mathbb Q)$ where $F:=\mathbb Q(a,b)$ is generated by $\operatorname{Gal}(F/\mathbb Q(i))$ and the complex conjugation.
$\operatorname{Gal}(F/\mathbb Q(i))$ has order $4$ and each element is completely determined by its action on $\alpha$. Therefore there exists $\sigma\in \operatorname{Gal}(F/\mathbb Q(i))$ such that $\sigma(\alpha)=-\beta$, now we have $\sigma(-\alpha)=\beta, \sigma(\beta)=\sigma(4i/\alpha)=4i/\sigma(\alpha)=4i/(-\beta)=-\alpha$, $\sigma(-\beta)=-\sigma(\beta)=\alpha$. In similar ways, we can figure out all four elements in $\operatorname{Gal}(F/\mathbb Q(i))$, and if we label $\alpha, -\alpha, \beta, -\beta$ as $1,2,3,4$ respectively
$$\operatorname{Gal}(F/\mathbb Q(i)) = \{(1), (12)(34), (13)(24), (14)(23)\}$$
Note that the complex conjugation is just $(34)$. Therefore
$$\operatorname{Gal}(F/\mathbb Q) = \langle (1), (12), (34), (13)(24)\rangle \simeq D_4$$
The permutaitons form $D_4$ because it's precisely the symmetric group of the square:
$$\require{AMScd}\begin{CD}
1 @= 3\\
@| @|\\
4 @= 2
\end{CD}$$