My purported proof: The number of $i$-cells in $X$ is $m_i$, the number of critical points of index $i$.
There is a Morse function $f$ on $M$ with $m_0=m_3=1$.
Since $M$ is an odd-dimensional manifold, $\chi(M)=0$.
By Poicaré-Hopf, $0=\chi(M)=-m_0+m_1-m_2+m_3$, so $m_1=m_2$.
$X$ gives $\pi_1(M)$ a presentation with $m_1$ generators and $m_2$ relators.