Seeing $\mathbb{Q}$ as an ordered set, the colimit of a diagram $D:\mathcal{I} \to \mathbb{Q}$, when it exists, is just $\operatorname{colim}D \cong \operatorname{sup}_iD(i)$.
It seems to me that given any diagram $D:\mathbb{Q} \to \mathcal{E}$ into a cocomplete category $\mathcal{E}$, it extends to a functor $L:\mathbb{R}\cup\{-\infty,+\infty\} \to \mathcal{E}$ given by $L(r)=\operatorname{colim}\{D(q):q \leq r, q\in \mathbb{Q}\}\in \mathcal{E}$.
This establishes $\mathbb{R}\cup\{-\infty,+\infty\}$ as the free co-completion of $\mathbb{Q}$. Moreover, we obtain the density result asserting that every real number is the sup of all smaller rational numbers as a corollary of the fact that every presheaf is a colimit of representables.
Proof: $L$ is a functor preserving colimits and extending $D$ by construction. Given another $L'$ with these properties, since every $r$ is the colimit (= sup) of all its smaller rational numbers, it must be $L \cong L'$.
Am I stating something wrong here? I just thought about it, and it seems a nice and elementary example, but I have not seen it stated anywhere, which is very strange, and makes me suspect I am missing something and there's something wrong?
The extension $L$ you describe does not preserve colimits in general. For instance, let $\mathcal{E}$ be the poset $\{0,1\}$ and let $D$ send the negative rationals to $0$ and the nonnegative rationals to $1$. Then your extension $L$ will send $[-\infty,0)$ to $0$ and $[0,\infty]$ to $1$. This does not preserve colimits because $\sup [-\infty,0)=0$.