For a module $M$ there is always a surjection $F \to M$ with $F$ free. As free modules are projective, there is always a surjection $P \to M$ with $P$ projective, and one may form the first syzygy $\Omega^1(M) := \text{ker}(P \to M)$. Iterating this process one obtains a projective resolution, and one can form the extension groups which can be shown to be independent of the choice of $P$ and the surjection.
The general impression I get from the stub Wikipedia article is that they here demand the modules to free, i.e. they form the syzygies (and thereby the extension groups) from a free resolution. While the word syzygy is never mentioned in Hatcher (I ctrl+F'ed it!), this seems to be the general approach taken in the formation of extension groups there as well.
As free implies projective, is this simply a case of "Yes, these things may be formed by projective modules, but for us it will be convenient to work with free modules" or is there a significant distinction to be made here? In particular, is it often the case that there is no surjection $P \to M$ with $P$ projective but not free?