Mysql – Why does MySQLTuner show query_cache_size (=0)

You have a server with 256M, but you can't use all of that -- remember there's some OS overhead. Add to that with the fact you're over committing as other folks have mentioned and you'll definitely thrash here. 256M is only enough for a small DB, 20 connections is a lot with what you've got configured.

1) reduce your max connections to 4 (you're using 3 out of 20)

2) optimize your query cache better; 8M is really large, and 64M total is a lot based on your hits/prunes; try a 4/32 combo and see how it goes. Really I think a 2/24 combo would work for you.

3) you have no sorts requiring temp tables, why is that max_heap_table_size verb in there? Comment that out, use the defaults

4) do you actually have 128 tables? Try cutting that table_cache in half to 64 or 48

5) reduce thread_cache_size to 4

6) optimize those tables to reduce fragmenting

Those are some things to start with. It looks like you threw a bunch of numbers in a config without any actual profiling to know what you needed and have created a mess; if all else fails go back to the defaults and get rid of your custom settings and start over using some performance tuning guides you can find on Google. Get the output of SHOW VARIABLES and SHOW STATUS, find any one of a bajillion tuning guides and plug in your actual, real numbers into their equations and that'll tell you the exact-ish numbers you need to put in your config file.

innodb_buffer_pool_size > 1G, because your dataset size is 1,8GB.

To decrease number of reads you need to increase innodb_buffer_pool_size. To decrease number of writes you need to edit your zabbix templates (disabling some unnecessary items like free inodes, increase intervals between checks).

You have Reads / Writes ratio at 57% / 43%, so enabling Query Cache will not help (it may make things worse, because writes to tables invalidates cache).

Think about increasing tmp_table_size and max_heap_table_size to avoid creating tmp tables on disk (13% of tmp tables). Temporary tables are in MB? it is count? If it is counter, its too high.

Decrease number of connection to 50 (your highest number was 33).

innodb_support_xa = false
innodb_buffer_pool_size = 256M # It depends how many memory is available to MySQL, more is better.
innodb_flush_log_at_trx_commit = 0 # disable writing to logs on every commit and disable fsync on each write
innodb_max_dirty_pages_pct = 90 # avoid flushing dirty pages to disk
innodb_flush_method = O_DIRECT # direct access to disk without OS cache
thread_cache_size = 4
query_cache_size = 0
table_cache = 80? # a little more than number_of_tables_in_zabbix_database

Usefull link about InnoDB optimization.