Try this:
"test7": {
"prefix": "al",
"body": [
// my version
"${RELATIVE_FILEPATH/^([^\\/\\\\]+[\\/\\\\])|(\\.ex|\\.exs)$|([^._\\/\\\\]+)|_|([\\/\\\\])/${3:/capitalize}${4:+.}/g}",
// your version tweaked
"${RELATIVE_FILEPATH/^(lib[\\/\\\\]|test[\\/\\\\])(\\w)|(\\.ex|\\.exs)$|([\\/\\\\])(\\w)|_(\\w)/${2:/upcase}${4:+.}${5:/upcase}${6:/upcase}/g}",
],
"description": "alert line"
}
[Note: I made these work for both path.separators / and \. If you don't need that you could shorten the snippet by a lot.]
Your version was very close. I changed it to \\.ex just to make the dots explicit.
I also added a 4th capturing group ([\\/\\\\]) just before the 5th as in ([\\/\\\\])(\\w).
Now that 4th group can be used in a conditional ${4:+.} to add the .'s where the path separators were.
My version is a little shorter - it matches but doesn't use whatever directory is first, be it lib or test or whatever. If that doesn't work for you it is easy to modify that bit of the regexp. I shortened it to 4 capture groups.
([^._\\/\\\\]+)|_|([\\/\\\\]) the end of my version:
([^._\\/\\\\]+) : match characters other than ._\/, or
_ : match it but we aren't using it so no need for a capture group, or
([\\/\\\\]) : match just the path separator in group 4 to use in the conditional.
${4:+.} : conditional, if there is a group 4 (a path separator) add a ..