In the narrowest sense, this use of "conjugate" refers more precisely to the following relation of numbers:
If $a$ and $b$ are rational numbers and $b$ is not a square of some other rational, then $a+\sqrt{b}$ and $a-\sqrt{b}$ are said to be conjugate.
This is basically the definition you give, with the addition that the term that changes sign has to be an irrational square root of a rational number.
However, this is not terribly illuminating about why this is a good definition. The basic idea is the following:
If all you have access to is arithmetic and rational numbers, then $a+\sqrt{b}$ and $a-\sqrt{b}$ cannot be distinguished from one another.
This is a wild idea that goes against how numbers are frequently taught - we're not considering decimal expansions of the ordering of numbers and this idea certainly can't live on a number line. To illustrate the point, suppose I consider a fixed conjugate pair $x_1=1+\sqrt{5}$ and $x_2=1-\sqrt{5}$. I can write statements such as
$$x_1^2=4+2x_1$$
which is a non-trivial and true fact using only basic arithmetic operations and rational numbers. Essentially, every "fact" about a number that we could write down this way boils down to saying that $x_1$ is a zero of some polynomial with rational coefficients - here, that polynomial is $x^2-2x-4$. However, here is the problem: every rational polynomial that has $x_1$ as a root also has $x_2$ as a root - so, there's no way for us to write some property that distinguished between these two things. However, there is no other number that could be conjugate, because the property $x^2=4+2x$ is only satisfied by two numbers: $x_1$ and $x_2$. It rules out everything else.
There's a ton of machinery to explore here, but a lot of the interest boils down to noting that, while we can define rational numbers like $8$ as the root of a linear polynomial like $x-8$, we cannot do the same for irrational numbers. Irrationals of the form $a+\sqrt{b}$ are special in that they are roots of quadratic polynomials. However, since each quadratic polynomial has two roots, we consider these to be related - and call that relation "conjugacy."
Often, note, that we are interested in using particular properties of the roots of a polynomial. For instance, we can write
$$x^2-2x-4 = (x-x_1)(x-x_2)$$
using my previous example. If we expand on the right side, we get
$$x^2-2x-4 = x^2 - (x_1+x_2)\cdot x + x_1x_2$$
which tells us that $x_1+x_2$ is $2$ and $x_1\cdot x_2$ is $-4$. When doing things like rationalizing a denominator, these properties are handy to know since they tell us that we can, by introducing the conjugate into an equation, make various things rational.
Another way to look at this whole idea is that if, one day, you woke up and all the $\sqrt{5}$'s had turned into $-\sqrt{5}$'s, you would never know! Why? Well, suppose you tried multiplying
$$(a+b\sqrt{5})\cdot (c+d\sqrt{5})$$
before the switch. You would end up with $(ac+5bd)+(bc+ad)\sqrt{5}$. After the switch, you would multiply
$$(a-b\sqrt{5})\cdot (c-d\sqrt{5})$$
and end up with $(ac+5bd)-(bc+ad)\sqrt{5}$ - but note that this is the same as if we'd computed the multiplication, then switched the sign. More formally, if we consider the set of numbers of the form $a+b\sqrt{5}$ for rational $a,b$ and let $f$ be a function taking $a+b\sqrt{5}$ to $a-b\sqrt{5}$, we get the relation
$$f(\alpha)f(\beta) = f(\alpha\beta)$$
$$f(\alpha)+f(\beta)=f(\alpha+\beta)$$
which basically tell you that $f$ is somehow compatible with arithmetic operations.
What we're dealing with is symmetries of arithmetic - there are certain ways that you can move numbers around while maintaining a consistent view of arithmetic. If $b$ is rational and $\sqrt{b}$ is not, you can freely switch $\sqrt{b}$ and $-\sqrt{b}$ as long as you're consistent about it. That's what conjugacy is. This is particularly useful since, as it turns out, $a+\sqrt{b}$ and $a-\sqrt{b}$ are the roots of some rational polynomial.
Now, this might leave you with lots of questions. For instance, why is it the case that we can come up with symmetries that exchange conjugate values? It seems like a nice coincidence as I present it here. Also, if we had two square roots, should we consider $1+\sqrt{2}+\sqrt{3}$ to be conjugate to all of $1-\sqrt{2}+\sqrt{3}$ and $1+\sqrt{2}-\sqrt{3}$ and $1-\sqrt{2}-\sqrt{3}$ since we can flip signs - and if so, does that mean there is some polynomial that has exactly these as roots, and no polynomial that distinguishes them from each other? (Yes and yes). Well, then is $1+\sqrt{2}+3\sqrt{8}$ conjugate to every expression with signs flipped? (No, because $\sqrt{8}$ and $\sqrt{2}$ are related). What about a number like $\sqrt[3]{2}$? Does it have conjugates?
Broadly speaking, there is an area of mathematics known as Galois theory that deals with these questions and opens up many more - and it can most succinctly be defined as the study of symmetries of arithmetic and this kind of conjugacy is perhaps the first step one encounters of this broad field.