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Albert Barnes and Edward D. Andrews write,

1 John 5:6 Updated American Standard Version (UASV)
⁶This is the One who came by water and blood, Jesus Christ, not with the water only, but with the water and with the blood. And the Spirit is the one who testifies, because the Spirit is the truth.

How did water, blood, and the Spirit testify to the fact that “Jesus is the One”? Water testifies because when Jesus was baptized in water, the Father personally stated His approval of him as His Son. (Matt. 3:17) Jesus’ blood, as he gave his life as “a ransom for all,” also testify that Jesus is the One, God’s Son. (1 Tim. 2:5-6) And the Holy Spirit testified that Jesus is the Son of God when John bore witness: “I saw the Spirit descend from heaven like a dove, and it remained on him.” So “God anointed Jesus of Nazareth with the Holy Spirit and with power. He went about doing good and healing all who were oppressed by the devil, for God was with him.”—John 1:29-34; Acts 10:38.

Daniel L. Akin,

5:6 In 5:11 John has explained that orthodox faith is based on the revelation and reality that Jesus is the Christ, the Son of God (5:5). He now underscores the reliability of this confession by providing witnesses. John states that Jesus “is the one who came by water and blood” and “he did not come by water only, but by water and blood.” This passage was no doubt clear to the original audience but, unfortunately, is somewhat obscure to us.¹⁸⁵ Three main interpretations of this passage have been offered.

The “water and blood” refer to baptism (water) and the Lord’s Supper (blood). This interpretation, which goes back to the time of the Reformers, is not without its difficulties. First, John is concerned with combating false teachers who denied the human nature of Jesus. It is therefore unlikely that John would now switch topics. Second, John uses the past tense (ho elthōn, “the one who came”) which reflects a past, completed event in history, whereas baptism and the Lord’s Supper are recurring observances. Third, although water seems to be a likely synonym for baptism, the same is not true for blood and the Lord’s Supper.
The “water and blood” are parallel to John 19:34–35, which speaks of a spear being thrust into Jesus’ side at the crucifixion that produced “blood and water.” Again, although this view can be found as far back as Augustine, it remains problematic. First, the order has been reversed. First John speaks of “water and blood,” but the Gospel of John reads “blood and water.” Second, if “water and blood” refer to the spear thrust, then how can it be said that Jesus “came” by them? Whereas the Gospel of John indicates that “blood and water” came from Jesus, here it is said that Jesus came “by” water and blood. Third, this view does not account for the statement in v. 8 that affirms that Jesus “did not come by water only, but by water and blood.”
The “water and blood” refer to the terminal points in Jesus’ earthly ministry: his baptism (water) and his crucifixion (blood). This is the best interpretation and is followed by most scholars. Historically, Jesus “came” into his power by the “water” of his baptism and even more so by the “blood” of his cross. Unlike the previous two views, this explanation fits the historical context of John’s epistle. John writes this letter to counter the Gnostic tendencies of the false teachers. These false teachers, who at one time were part of the fellowship (2:19), were denying the humanity of Jesus, and so John emphasizes the reality of the Incarnation. John’s further qualification that Jesus came “not by water only, but by water and blood” is likely a direct renunciation of the false teaching (perhaps that of Cerinthus) that claimed that Jesus was born an ordinary human being but became God’s special agent when the heavenly Christ descended upon him at his baptism. The heavenly Christ abandoned him before his death and, consequently, it was only the earthly Jesus who died on the cross. In seeking to refute this teaching, John emphasizes that it was Jesus Christ who experienced both baptism and crucifixion. Marshall eloquently explains the importance of John’s teaching.

As soon as we reduce the death of Jesus to that of a mere man, so soon do we lose the cardinal point of the New Testament doctrine of the atonement, that God was in Christ reconciling the world to himself; in the last analysis, the doctrine of the atonement means that God himself bears our sins and shows that the final reality in the universe is his sin-bearing, pardoning love, but if Jesus is not the Son of God, his death can no longer bear this significance. So-called theologies, which reduce talk of the incarnation to the status of myth, may be attractive to modern men, but they take away our assurance that God’s character is sin-bearing love.

In support of Jesus’ historical life and death, John appeals to the testimony of the Spirit. The witness of the Spirit is needed because Jesus’ divinity is a scandal and a stumbling block to the world. The Spirit can be trusted since he is the truth and therefore speaks God’s truth (John 14:17; 16:13). The Spirit speaks through the Word, convicting the heart of the individual. Jesus makes a similar statement in John’s Gospel concerning the role of the Spirit: “When the Counselor comes, whom I will send to you from the Father, the Spirit of truth who goes out from the Father, he will testify about me” (John 15:26).^[1]

^[1] Daniel L. Akin, 1, 2, 3 John, vol. 38, The New American Commentary (Nashville: Broadman & Holman Publishers, 2001), 195–197.