You can see some holes in the walls, but I don't know enough to say if this explosion was specifically engineered to cause shrapnel damage (maybe not). Israel has bombs that can be set to explode in the air. Hamas rockets are very simple and can't do this, you need a doppler radar for that . And if you look at the damage other than the crater, there's plenty of damage tens of meters away, on the sides and roofs of buildings, on treetops, on cars with the dented in roofs that aren't very close to the crater. On pretty much all sides of that courtyard. This is too large of a radius for one those small rockets that Hamas & co are firing. Never have I seen or heard of any of those rockets causing this much damage.

And I've read these OSINT threads on twitter, they're saying it's rocket + fire damage from unspent fuel (hence the burning cars), but they're just looking at the radius of burned out cars and the small crater. They're totally ignoring the damage that's further away, and so that explanation does not make sense when you include that evidence.

There's also plenty of circumstantial shit, like Israel shelling this hospital as a warning two days earlier, and telling them to evacuate. Al Jazeera also documented that there were other Israel airstrikes within the same couple of minutes in the area, which btw create a very similar sound and fireball. Then there's the voice recording that according to the experts in this article here is an Israeli fake.

So, the explosion is inconsistent with a Hamas rocket, but not with an attack from Israel. Israel practically announced that shit and they've been caught lying about it now multiple times.