Might be worth proofing out. I believe the MS stuff is (finally) native to the platform, and should be fast and clean, without extra dependencies. I admit, it's been a while since I've hammered on a lot of .NET code in my every day(~4 years). I got really spoiled coding REST APIs in Node, and writing Swift and Flutter code for mobile. I still do a bit of it, but just not my every day stuff any more.
FWIW, if you want to entertain some Node coding, there are several PDF generation libraries that run in Node, and from what I've seen they're pretty clean and tight, memory wise, and in at least one case they're spawned out to a new process that's monitored by the library you call in your Node code. But if you're constricted to Azure, I think you already have a real clean road ahead of you with the .NET stuff.