Clinical data analysis and forecasting have made substantial contributions to disease control, prevention and detection. However, such data usually suffer from highly imbalanced samples in class distributions. In this paper, we aim to formulate effective methods to rebalance binary imbalanced dataset, where the positive samples take up only the minority. We investigate two different meta-heuristic algorithms, particle swarm optimization and bat algorithm, and apply them to empower the effects of synthetic minority over-sampling technique (SMOTE) for pre-processing the datasets. One approach is to process the full dataset as a whole. The other is to split up the dataset and adaptively process it one segment at a time. The experimental results reported in this paper reveal that the performance improvements obtained by the former methods are not scalable to larger data scales. The latter methods, which we call Adaptive Swarm Balancing Algorithms, lead to significant efficiency and effectiveness improvements on large datasets while the first method is invalid. We also find it more consistent with the practice of the typical large imbalanced medical datasets. We further use the meta-heuristic algorithms to optimize two key parameters of SMOTE. The proposed methods lead to more credible performances of the classifier, and shortening the run time compared to brute-force method.