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If you're looking for Rebirth/Afterbirth modding, check moddingofisaac.com and its help page. Don't expect much from them though, you'll mostly find retextures, replacement sounds, small stuff like that. It wasn't possible to do more than that back then (no real new content like real custom characters or brand new items). Except Antibirth, but that's the only .exe mod I know of (mods editing the game launcher itself) and it took years to make.
You need the afterbirth dlc to mod extensivly
base game mods are mostly just retextures