A quasi-two-dimensional system of hard spheres strongly confined between two parallel plates is considered. The attention is focused on the macroscopic self-diffusion process observed when the system is seen from above or from below. The transport equation, and the associated self-diffusion coefficient, are derived from a Boltzmann-Lorentz kinetic equation, valid in the dilute limit. Since the equilibrium state of the system is inhomogeneous, this requires the use of a modified Chapman-Enskog expansion that distinguishes between equilibrium and nonequilibrium gradients of the density of labeled particles. The self-diffusion coefficient is obtained as a function of the separation between the two confining plates. The theoretical predictions are compared with molecular dynamics simulation results and a good agreement is found.