math.h first appears in 7th Research Unix. It is hard to tell how it got there. For example, [1] claims that bits of C library were merged from "PWB/Unix" which included troff and C compiler pcc, but I cannot prove it.

Another interesting piece of information is library manual from V7 Unix: intro.3:

(3)   These functions, together with those of section 2 and those marked (3S),
      constitute library libc, which is automatically loaded by the C compiler
      cc(1) and the Fortran compiler f77(1).  The link editor  ld(1)  searches
      this  library  under  the  `-lc' option.  Declarations for some of these
      functions may be obtained from include files indicated on the  appropri-
      ate pages.

<...>

(3M)  These  functions  constitute the math library, libm.  They are automati-
      cally loaded as needed by the Fortran compiler f77(1).  The link  editor
      searches  this  library  under the `-lm' option.  Declarations for these
      functions may be obtained from the include file <math.h>.

If you look into V7 commands makefiles, only few C programs are linked with -lm flag. So my conclusion is speculative:

1. libm.a (and math.h) was primarily needed for FORTRAN programs mostly, so it was separated into library to reduce binary footprint (note that it was linked statically).
2. Not many machines had floating point support. For example, you would need to buy an optional FPP for PDP-11 [2], there is also libfpsim simulation library in Unix to mitigate that, so floating point can be hardly used in early C programs.

1. A History of UNIX before Berkeley: UNIX Evolution: 1975-1984

^{2. PDP-11 architecture}