Because the spam mails created by Emotet look a lot more like genuine e-mail traffic, they're a lot harder to detect for both humans and spam filters. The botnet spreads itself via a malicious attachment, that relies on further social engineering and Office macros to download a payload.
"It's easy to see how someone expecting an email as part of an ongoing conversation could fall for something like this, and it is part of the reason that Emotet has been so effective at spreading itself via email," Talos researchers wrote in the post. "By taking over existing email conversations and including real Subject headers and email contents, the messages become that much more randomized and more difficult for anti-spam systems to filter."