The idea is that we want to allow our theorems to depend not only on $a$ and $b$, but also on the particular proof of equality! Here I'm assuming $r(a) : I(a,a)$ is reflexivity.
It's tricky to reason about what this means, since it's consistent that the only proofs of type $I(A,a,b)$ are reflexivity (this is called axiom k). That is, it's possible that $c$ is always $r(a)$! In fact, many "natural" models
have exactly this property! Models where this property fails are called "proof relevant", and the idea is that types $C(a,b,c)$ might depend on which particular proof $c : I(A,a,b)$ we're given!
It's extremely surprising that we can understand terms of type $C(a,b,c)$ just by understanding terms of type $C(a,a,r(a))$. More than most induction principles, this feels like we're getting something for free. So when it comes to being confused by this principle, you're in very good company! Lots of people (myself very much included) have struggled with this, and there's a lot of resources for trying to understand it (see here, for instance).
The most natural way to understand the dependence on $c$, at least in my mind, is through the homotopy theoretic interpretation. So let's take a moment to talk about that. Here types are geometric spaces, and terms $a : A$ are points in $A$. Now, in homotopy theory, when do we consider two points to be "the same"? Precisely when there's a path from $a$ to $b$ in $A$. But now it should be very clear that there are multiple possible paths from $a$ to $b$, and thus multiple possible proofs of $I(A,a,b)$.
So now say we have a proposition $C$ which depends on $a,b$ as well as the path $p : I(A,a,b)$. For instance, we might have
$$C(a,b,p) = \prod_{p : I(A,a,b)} \sum_{q : I(A,b,a)} p \cdot q = r(a)$$
where homotopy theoretically we interpet $p \cdot q$ as the concatenation of the paths $p$ and $q$ (I'll not formally define it, though).
The magical thing (called "path induction" in this context) is that to prove the above claim for every $a,b,p$, it suffices to prove it for $a,a,r(a)$! Again, I agree that it's far from obvious that this should work. But here's a homotopy theoretic justification:
One can show that the space of paths one one endpoint fixed and one endpoint free is contractible, in the sense that, for any two such paths (which are now points in the space of all paths) there is a path between them (in the space of all paths). In the type theoretic interpretation, this is saying that for any two proofs $p,q : \sum_{b : A} I(A,a,b)$ there is a proof of $I \left ( \sum_{b : A} I(A,a,b), p, q \right )$. But this is good, because it means that every such proof is equal to $(a,r(a)) : \sum_{b : A} I(A,a,b)$. And we know that we can substitute equal things, so once we've proven $C(a, (a,r(a))$ we can substitute to get a proof of $C(a, (b,c))$ (where I've silently uncurried $C$. Obviously this isn't an issue).
Edit:
In the comments you bring up a reasonable point, that bringing in homotopy theory seems like some heavy duty machinery for something comparatively simple. Here's a (possibly anachronistic) view of how this might have been developed and understood in a pre-HoTT world.
First, remember that we use elimination rules in order to define functions. For instance, the elimination rule for $\mathbb{N}$ exactly says that we can define functions on $\mathbb{N}$ by recursion. So, if we want to be able to define functions out of an identity type $I(A,a,b)$, then we need the elimination rule to give us something of the form $J : C(a,b,p)$, where of course $p : I(A,a,b)$. That way we know where to send a given proof of equality $p$.
Now, you might say "if $r(a)$ is the only proof, can't we leave it as an implicit argument?" and while we probably could, it's fairly standard to not.
For instance, we define the type $\mathbf{1}$, which we want to think of as having exactly one inhabitant, $\star : \mathbf{1}$. But the way we encode that is with an elimination rule called singleton induction:
$$
\frac{{}}{\star : \mathbf{1}}\ \ (\mathbf{1} \text{ intro})
\quad \quad
\frac{c : C(\star) \quad x : \mathbf{1}}{\mathtt{ind}_\mathbf{1}(C,c,x) : C(x)}\ \ (\mathbf{1} \text{ elim})
$$
It's then a theorem in the type theory that $\prod_{x : \mathbf{1}} x=\star$, so we don't need to specify uniqueness in the metalanguage. This is because our elimination rule says that the value of a function on $\mathbf{1}$ is completely determined by its action on $\star$.
Of course, our approach to the identity type is entirely analogous. Even if we're thinking of $I(A,a,b)$ as being either empty or uniquely inhabited, it's "more hygenic" in a sense to leave that as a theorem in the type theory, rather than try to force it in the metalanguage. This leads us to do exactly what we did with singleton induction. Since we want the entire type to be generated by $r(a)$, we define introduction and elimination rules:
$$
\frac{a : A}{r(a) : I(A,a,a)}\ \ (I\text{ intro})
\quad \quad
\frac{c : C(a,a,r(a)) \quad p : I(A,a,b)}{\mathtt{ind}_{I}(C,c,p) : C(a,b,p)}\ \ (I\text{ elim})
$$
these are entirely analogous to the rules for singletons, and indeed we can prove inside the theory that
$$\prod_{(b,p) : \sum_{b : A} I(A,a,b)} (b,p) = (a,r(a))$$
I wasn't there, but I suspect it came as a surprise when people first realized that there are models of this type theory where the identity type can have more than one element.
I hope this helps ^_^