In most states, cars themselves don't have many requirements/checks post-sale. Some states check that emissions equipment is still functioning, but because this is often done by third parties, cheating is rampant. Still some states require safety inspections, but that is far in the minority.

ADAS systems are mostly legal because they are officially "assistance" systems, and the driver is still responsible for whatever the vehicle does. There is exactly one commercially non-assistance "self driving" system that I am aware of in the world, and it's made by Mercedes Benz, and is only operable in very specific situations. MB takes responsibility for what happens when the vehicle is operating in this mode.

I've lived in several states with annual safety/emissions inspections (VA, PA). Virginia certainly used to check the aim of headlights (30+ years ago), but probably don't any more. I imagine that the wide range of headlight designs today makes adjustment too complex for most inspectors to do, much less owners.

What do you think happens in a non-self driving car wen the driver accelerated into a firetruck?

In that case, a person is 100% at fault for pressing the gas pedal, and there's a good chance that responsible party gets real consequences. In the Tesla case, there's a good chance that the meatbag is just a stooge and the algorithm gets to keep on driving.

That doesn’t generally happen with human drivers.

Whitney Houston drove her car into a transit bus.

There's an entire agency dedicated to it: NHTSA issues the FMVSS.

You should see how hard it is to import any car that is not also produced for the US market.