There must not have been much blood in the game because the esrb does not tell devs what specific thing pushed them over for their rating. So if they gave it a T for blood and that’s the only thing with blood that would narrow it down. The more insidious part is the esrb will charge the same amount if they reapply for a rating (and it’s not cheap).

So say a devs market research says their game would do best marketed for Teen audience but one thing in one level pushes what the devs thought would be considered a suggestive theme over the line into sexual content. Earning it an M. Now the devs has to guess what specific thing crossed the line, change it, and pay again and resubmit if they want to get a T rating. And hoping that they guessed the thing that the one rater said crossed the line. And there is no guarantee the same person is even rating the game.